Low dose CT guided percutaneous sacroiliac screw fixation

ABSTRACT

To describe the procedure and compare the radiation to the patient between a conventional CT and low dose CT and show the percentage reduction of dose to the patient under the latter protocol whilst still ensuring clinical efficacy. The study was performed in a 100 bed secondary care hospital which caters principally to the local industrial community. Patients were included in the presence of an unstable pelvic ring injury requiring posterior ring fixation. However, patients who were haemodynamically unstable; patients with head, thoracic and extensive abdominal wounds, and those who might require an open reduction procedure for posterior pelvis repair were excluded from the study. The low dose CT scan image quality was satisfactory for planning the procedure. Also, with CT guidance, the placement of screws in all cases was exactly as desired with a high level of confidence there was no complications. Fixation of sacroiliac joint fractures under CT guidance is easier than with conventional fluoroscopic guidance or open surgery. The procedure can be done even in a small set-up. Low dose CT guidance makes it more acceptable for patients and surgeons