Computer assisted versus conventional surgery for insertion of 96 cannulated iliosacral screws

摘要

Introduction: Advantages of percutaneous iliosacral screw fixation include minimal invasion of soft tissue, limited blood loss and decreased infection rates [1]. During the operation, a guide-wire for the cannulated screw is drilled across the ilium and targeted in the first or second sacral vertebral body, using intraoperative fluoroscopic control. This technique requires a high degree of "three-dimensional thinking (3D)" and an expert knowledge of the anatomy of the pelvis. The purpose of this study was to assess the value of fluoroscopy based CAS for the insertion of iliosacral screws in the clinical situation. The results of CAS were compared with the results of a conventionally operated prospective control group. Endpoints of this study were fluoroscopy time, operation time and complication rate. Patients and Methods: The study group consisted of 24 patients with post partum pelvic pain syndrome. All patients were treated with a stabilization of the pelvic ring by means of an anterior plate fixation and autologous tricortical bone graft as well as two iliosacral screws bilaterally. The control group consisted of twelve prospective conventionally operated patients. Both patients groups were identical for age and preoperative morbidity. Consequently, the results of 48 versus 48 iliosacral screw fixations could be evaluated and compared. One surgeon performed all operations.