Computed axial tomography-guided fixation of sacroiliac joint disruption: safety, outcomes, and results at 3-year follow-up.
Secondary to the progress in interventional imaging, new therapeutic options have been developed that decrease potential complications because they are minimally invasive and they decrease patient rehabilitation time. As a diagnostic modality, computed axial tomography (CAT) allows precise evaluation of the degree of sacroiliac reduction that must be performed. Moreover, the use of CAT enables easy positioning of screws across the sacroiliac joint, thus avoiding nerve and vascular damage. We report our clinical experience of 20 patients treated by CAT-guided percutaneous fixation for posttraumatic unilateral sacroiliac disruption, including evaluation of our technique, its safety, and patient outcomes and long-term results. All patients in this study had successful outcomes, which were judged according to how much pain they experienced and how quickly they resumed normal activity after the procedure. Twelve of 16 patients were able to return to work by postoperative month 2. One patient had degenerative sacroiliac joint syndrome (5%), which was confirmed 6 months after surgery by CAT scan. None of the patients showed radiologic or clinical evidence of instability of the sacroiliac joint or screw migration. Postoperative follow-up, performed at 1, 2, and 3 years in our rehabilitation department, showed stable results over time. All pain disappeared, without the need for medication, in 19 patients (95%).
Amoretti
Nicolas
N
Radiology Department, University Hospital, Centre Hospitalier Universitaire de Nice, Route de saint Antoine de Ginestiere, 06200, Nice, France. amorettinicolas@yahoo.fr
Hovorka
Istvan
I
Marcy
Pierre-Yves
PY
Hauger
Olivier
O
Amoretti
Marie-Eve
ME
Lesbats
Virginie
V
Brunner
Philippe
P
Maratos
Yvonne
Y
Stedman
Susan
S
Boileau
Pascal
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery*; D012449:Safety; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome