title: Sacropelvic fixation with iliosacral screws: applications and results in adult spinal deformities.
abstract: METHODS
  Retrospective radiographic and clinical review.
  
  
  OBJECTIVE
  To determine the feasibility of iliosacral screw fixation in adult spinal deformations.
  
  
  BACKGROUND
  Pelvic fixation is one of the most challenging instrumentation problems. The poor bone quality frequently found within the sacrum and the large lumbosacral loads with cantilever pullout forces across this region explain its frequent failure.
  
  
  METHODS
  Fourteen adult patients undergoing pelvic fixation using iliosacral screws with a minimal follow-up of 24 months were analyzed for radiographic outcomes. Radiographic data included the localization of the spinal deformity, the Cobb angle, T4-T12 thoracic kyphosis, L1-S1 lumbar lordosis, the T9 tilt, the pelvic parameters, and the POA. Mechanical and infectious complications were also noted.
  
  
  RESULTS
  The lumbo-pelvic correction was performed with a large reduction of the POA in every case. The frontal and sagittal corrections obtained with this procedure were considered as being effective. There were no mechanical complications due to failure of the instrumentation, loss of sacral fixation, or loss of lumbar lordosis at the time of the last follow-up. One patient experienced local infection on the left iliosacral screw without any residual functional sequel.
  
  
  CONCLUSIONS
  Iliosacral screwing can offer a pelvic fixation reliable enough to allow restoration of 3-dimensional trunk balance. This technique has a quite short learning curve and adequately permits frontal and sagittal corrections, increases stability, and decreases instrumentation-related complications. Our observations suggest that it is applicable to pelvic fixation in adult surgery.
authors: Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, France.
authors: Mourad
authors: M
authors: Ould-Slimane
authors: Lotfi
authors: L
authors: Miladi
authors: Marc-Antoine
authors: MA
authors: Rousseau
authors: Raphael
authors: R
authors: Bonaccorsi
authors: Yves
authors: Y
authors: Catonne
authors: Jean-Yves
authors: JY
authors: Lazennec
authors: Hugues
authors: H
authors: Pascal-Moussellard
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007085:Ilium / Q000601:surgery*; D016268:Internal Fixators; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D013121:Spinal Curvatures / Q000000981:diagnostic imaging* / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult