Introduction: Percutaneous screw fixation is a widely used treatment for posterior pelvic ring injuries. Transiliac-transsacral screw fixation has demonstrated superior biomechanical properties over bilateral sacroiliac screws, particularly in the minimally displaced bilateral sacral fractures. Screw placement under fluoroscopic control is still common, while CT navigation is gaining popularity. However, the accurate placement of screws within a safe zone is essential to avoid neurovascular complications.
Methods: An anatomical study using human cadaveric pelves was conducted to assess radiological landmarks and determine a safe zone in relation to the S1 recess/foramen for transiliac-transsacral screw placement.
Results: Fourteen pelves were evaluated. Ten pelves were classified as having a satisfactory corridor for screw placement, while four were deemed to have an impossible or high-risk corridor. A safe zone was defined based on the diagonal bisector of the S1 vertebral body, ICD and anterior cortex.
Discussion: The study findings suggest that lateral fluoroscopic projection can determine a safe entry point for screw placement. Understanding the anatomy and landmarks on lateral fluoroscopic images is crucial for successful screw placement and avoiding complications.
Conclusion: The S1 body diagonal is consistently located anterior to the S1 recess in lateral fluoroscopic projections, providing a potential safe corridor for transiliac-transsacral screw placement at the S1 level in nondysmorphic pelves. Further research is needed to confirm these findings with CT imaging and evaluate the technical feasibility of screw placement.
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http://dx.doi.org/10.1007/s00590-024-04157-5 | DOI Listing |
PLoS One
December 2024
Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands.
The demographic shift has increased the demand for surgical interventions to address age-related degenerative diseases, such as spinal fusion. Accurate placement of pedicle screws, crucial for successful spinal fusion, varies widely with physician experience. Integrating tissue sensing into spine surgical instruments allows intraoperative examination of tissue properties, providing surgeons with additional information to prevent screw misplacement.
View Article and Find Full Text PDFPLoS One
December 2024
Bio-Inspired Technology Group, Faculty of Mechanical Engineering, Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Pedicle screws have long been established as the gold standard for spinal bone fixation. However, their fixation strength can be compromised in cases of low bone density, particularly in osteoporotic bone, due to the reliance on a micro-shape lock between the screw thread and the surrounding bone. To address this challenge, we propose augmenting conventional pedicles screws with a curved compliant anchor.
View Article and Find Full Text PDFInt J Implant Dent
December 2024
Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
Purpose: to quantify the soft tissue dimensional changes after single-gap implant placement, during healing abutment and crown delivery phase for butt-joint and conical implant-abutment connection type.
Methods: forty patients were enrolled in the study and received randomly allocated implants with butt-joint and conical implant-abutment connection type. A standard healing abutment was placed after 6 months for two weeks.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
December 2024
Department of Orthopedics, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou Sichuan, 646000, P. R. China.
Objective: To investigate ideal screw implant angle in reconstruction of tibiofibular syndesmosis injury by using a biomechanical test.
Methods: A total of 24 ankle specimens from adult cadavers were used as the tibiofibular syndesmosis injury model. According to the angle of screw placement, the tibiofibular syndesmosis injury models were randomly divided into groups A (0°), B (10°-15°), C (20°-25°), and D (30°-35°), and the screws were placed at a level 2 cm proximal to the ankle joint.
J Am Acad Orthop Surg
December 2024
From the Department of Orthopedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Lumbar pedicle screw placement in spinal surgery is complex and prone to errors, with notable risks to patients. Standard training methods, such as mentorship in operating rooms, pose safety concerns, prompting the need for alternative training tools. This study aimed to validate and use a three-dimensional (3D)-printed simulation model for lumbar pedicle screw insertion training and assess its effectiveness compared with standard methods.
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