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Radio-anatomical study of anterior–posterior placement sacroiliac screw channel

Abstract

Purpose

The outlet of the classic sacroiliac screw (SIS) cannot be precisely controlled by aiming devices, which may lead to malpositioned implants and neurovascular and visceral injury. This study aimed to radio-anatomically measure the parameters of the channel for anterior–posterior placement SIS (AP-SIS), which can be placed percutaneously with an aiming device.

Methods

Pelvic CT scan data of 80 healthy adults (40 males and 40 females) with an average age of 45 years (range 20–70 years) were collected. The length (L), width (W), height (H), cortical bone spacing (M), camber angle (E), anteversion angle (F), cross-sectional safety angle (P) and sagittal safety angle (Q) of the channel were measured by CT or Mimics software.

Results

The L, W, H, M, E, F, P and Q measures of S1 were 109.2 ± 8.0 mm, 18.5 ± 1.9 mm, 21.7 ± 1.7 mm, 8.1 ± 0.4 mm, 44.2 ± 3.2°, 42.4 ± 3.6°, 16.8 ± 1.1°, and 19.4 ± 2.0°, respectively, for S1, and 113.5 ± 9.4 mm, 18.2 ± 1.5 mm, 21.7 ± 1.7 mm, 7.7 ± 0.4 mm, 44.7 ± 3.2°, 31.2 ± 2.7°, 13.8 ± 1.0° and 15.4 ± 1.4°, respectively, for S2. Of the L measures, the intra-iliac segment was slightly longer than the intra-sacral segment. All parameters showed significant sex-related differences (p < 0.05).

Conclusion

The AP-SIS channels of S1-2 have sufficient width and length to accommodate a cancellous screw with a Φ 7.0–8.0 mm and a length 90–130 mm. The intra-iliac segment is a long channel screw with better mechanical properties over classic SIS.

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Availability of data and materials

Not applicable.

Abbreviations

SIS:

Sacroiliac screw

SAIS:

Sacral–alar–iliac screw

AP-SIS:

Anterior–posterior placement sacroiliac screw

S1:

First sacral vertebra

S2:

Second sacral vertebra

L :

Length of the channel

W :

Width of the channel

H :

Height of the channel

E :

Camber angle

F :

Anteversion angle

P :

Cross-sectional safety angle

Q :

Sagittal safety angle

M :

Cortical bone spacing

AIIS:

Anterior inferior iliac spine

ICD:

Iliac cortical density

ICC:

Intraclass correlation coefficient

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Acknowledgements

The authors would like to express their gratitude to EditSprings (https://www.editsprings.com/) for the expert linguistic services provided.

Funding

This study was supported by Project of Academician Qiu Guixing workstation of Wuxi No. 9 People's Hospital (No. JY2020-02), the Top Medical Expert Team of “Taihu Talent Program” in Wuxi (2020) (TTP-TMET2020-09). The beneficiaries of the funds were Yunhong Ma and Qudong Yin.

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Authors and Affiliations

Authors

Contributions

WCB, YQD and GSJ reviewed the literature, collected, and analyzed the data and wrote the manuscript. MYH, LY and WCB analyzed the data, final reviewed the literature and were responsible for the project and manuscript.

Corresponding authors

Correspondence to Yunhong Ma or Qudong Yin.

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conflict of interest

The authors declare no competing interests.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional standards. Ethics committee approval was obtained for this retrospective study (No. KT2021012; registration date: May 2021, retrospective registration), which abandoned the written consent of patients.

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Cite this article

Wang, T., Wei, C., Gu, S. et al. Radio-anatomical study of anterior–posterior placement sacroiliac screw channel. Eur Spine J (2022). https://doi.org/10.1007/s00586-022-07257-0

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  • DOI: https://doi.org/10.1007/s00586-022-07257-0

Keywords

  • Sacroiliac screw
  • S2AI
  • Radiology
  • Anterior–posterior placement
  • Aiming device