|
KMID : 1189320200140020177
|
|
Asian Spine Journal
2020 Volume.14 No. 2 p.177 ~ p.184
|
|
|
The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up
|
|
Nakashima Hiroaki
Kanemura Tokumi
Satake Kotaro
Ito Kenyu
Ishikawa Yoshimoto
Ouchida Jun
Segi Naoki
Yamaguchi Hidetoshi
Imagama Shiro
|
|
|
Abstract
|
|
|
Study Design: A retrospective cohort study.
Purpose: The purpose of this study was to investigate the prevalence and risk factors for S2 alar-iliac (SAI) screw loosening following lumbosacral fixation, with a minimum 2-year follow-up.
Overview of Literature: Although SAI screws allow surgeons to perform lumbosacral fixation with a low profile and enhanced biomechanical strength, screw loosening following surgery can occur in some cases. However, few studies have investigated the prevalence and risk factors for SAI screw loosening.
Methods: This retrospective study included 35 patients (mean age, 72.8±8.0 years; male, 10; female, 25) who underwent lumbosacral fixation using SAI screws with at least 2 years of follow-up. SAI screw loosening and L5?S bony fusion were assessed using computed tomography. The period for which the screws appeared loose and the risk factors for SAI screw loosening were investigated 2 years after surgery.
Results: A total of 70 SAI screws and 70 S1 pedicle screws were inserted. Loosening was observed 0.5, 1, and 2 years after surgery in 17 (24.3%), 35 (50.0%), and 35 (50.0%) SAI screws, respectively. Bony fusion rate at L5?S was significantly lower in patients with SAI screw loosening than in those without screw loosening (65.0% vs. 93.3%, p =0.048). The score for SAI screw contact with the iliac cortical bone and the bony fusion rate at L5?S were significantly lower in the loosening group than in the non-loosening group (1.8±0.5 vs. 2.2±0.3, p <0.001, respectively). Postoperative pelvic incidence?lumbar lordosis was significantly higher in the loosening group than in the non-loosening group (7.9°±15.4° vs. 0.5°±8.7°, p =0.02, respectively).
Conclusions: SAI screw loosening is closely correlated with pseudoarthrosis at L5?S. Appropriate screw insertion and optimal lumbar lordosis restoration are important to prevent postoperative complications related to SAI screws.
|
|
|
KEYWORD
|
|
|
S2 alar-iliac screw, Bony fusion, Screw loosening, Risk factors
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
|
|