title: Percutaneous Sacroiliac Screw Technique.
abstract: Remembering that preoperative planning, surgical indications, and fracture reduction are paramount for this procedure, presented here is our technique for performing percutaneous sacroiliac screws, both transiliac-transsacral and sacral style. A combination of video, still pictures, and fluoroscopy images will guide the viewer through the process we routinely use highlighting specific details. Patient positioning and intraoperative fluoroscopy imaging are critical to a successful procedure. Although inlet and outlet films remain important, we find the procedure best started on the lateral sacral view to reduce the need for start site, trajectory, and imaging position changes during the case. A cannulated pig sticker (drill guide) used with long drill tip guide wires provide improved manual control to both finding a good start site and directing the trajectory. For patient safety, sacral anatomy and safe zones are discussed as well. Using these technical points will help make this a successful procedure.
authors.affiliation: *Department of Orthopaedics, UCSF Fresno, Fresno, CA; †West Virginia University School of Medicine; and ‡Department of Orthopaedics, Penn State University, Hershey, PA.
authors.forename: John
authors.initials: J
authors.lastname: Tidwell
authors.forename: Rosa
authors.initials: R
authors.lastname: Cho
authors.forename: J Spence
authors.initials: JS
authors.lastname: Reid
authors.forename: Henry
authors.initials: H
authors.lastname: Boateng
authors.forename: Carol
authors.initials: C
authors.lastname: Copeland
authors.forename: Edward
authors.initials: E
authors.lastname: Sirlin
mesh_terms: D001863:Bone Screws; D019317:Evidence-Based Medicine; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome