Iliac bolt fixation: an anatomic approach.
METHODS
An illustrative technique display and discussions.


OBJECTIVE
Review of traditional and new "anatomic" techniques for placement of iliac-spinal fixation.


BACKGROUND
Placement of iliac fixation traditionally has been performed using offset connectors, devascularizing the iliac muscles, in addition to the posterior iliac spine. The technique reviewed provides for the screw heads to be placed in a more anatomic position, allowing rods to be laid parallel without the detachment of the erector spinous muscles.


METHODS
Utilization of anatomic models and discussion of present surgical technique for iliac bolt fixation (traditional) compared and contrasted to newer technique using the anatomic landmarks and structures of the iliac crest.


RESULTS
The anatomic models illustrate and support the utilization of an anatomic technique for fixation due to the lessening of muscle trauma, alignment of the rod systems, and preservation of the cortical surfaces.


CONCLUSIONS
The anatomic placement of iliac bolts provides for improved alignment of constructs while addressing spinal deformities. It may also increase screw pullout and construct strength.
Harrop
James S
JS
Departments of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PN, USA. James.harrop@jefferson.edu
Jeyamohan
Shiveindra B
SB
Sharan
Ashwini
A
Ratliff
John
J
Vaccaro
Alexander R
AR
D006801:Humans; D007085:Ilium / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D016268:Internal Fixators / Q000592:standards* / Q000639:trends; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008953:Models, Anatomic; D018908:Muscle Weakness / Q000209:etiology / Q000517:prevention & control; D018482:Muscle, Skeletal / Q000098:blood supply / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013121:Spinal Curvatures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*