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Optimal insertion positions of anterior–posterior orientation sacroiliac screw

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Abstract

Purpose

To explore the optimal insertion positions of anterior–posterior orientation sacroiliac screw (AP-SIS).

Methods

Pelvic CT data of 80 healthy adults were employed to measure the anatomical parameters including the insertable ranges of S1 and S2, the length, width and height of the channel with three different horizontal and vertical anterior insertion points starting from the ilium-acetabular recess. To compare pelvic stability by replicating a type C Tile lesions, fifteen synthetic pelvises were fixed with an anterior plate and a posterior AP-SIS employing different anterior insertion points, the whole specimen displacements and shifts in the sacroiliac gap under a cyclic vertical load of 300 N in a biomechanical machine recorded.

Results

The posterior and anterior insertable ranges averaged 17.9 × 8.5mm2 and 47.1 × 21.2 mm2, respectively. The channel lengths for three horizontal anterior insertion points gradually decreased from front to back with significant difference (p < 0.05), whereas the width and height for three horizontal anterior insertion points and the parameters for the three vertical anterior insertion points were similar (p > 0.05). The displacements and shifts for three horizontal insertion points gradually increased from front to back (p < 0.05) whereas the measurements involving the three vertical insertion points were similar (p > 0.05).

Conclusion

The posterior insertable range is small, where the center between adjacent nerve roots (foramens) is the optimal posterior insertion point. The anterior insertable range is large, where the iliac-acetabular recess is the optimal anterior insertion point for S1 and S2, providing the longest channel and best stability.

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Data availability

Not applicable.

Abbreviations

SIS:

Sacroiliac screw

AP-SIS:

Anterior–posterior orientation sacroiliac screw

SAIS:

Sacral alar-iliac screw

S1:

First sacral vertebra

S2:

Second sacral vertebra

S3:

Third sacrum

L :

Channel length

W :

Minimum width

H :

Minimum height

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 Ma YH and Yin QD.

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Authors and Affiliations

  1. Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, No. 999 Liangxi Road, Wuxi, 214062, Jiangsu, China

    Xiaofei Han, Zhihai Cao, Kai Zhao, Zhenzhong Sun, Yunhong Ma & Qudong Yin

Authors
  1. Xiaofei Han
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  2. Zhihai Cao
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  3. Kai Zhao
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  4. Zhenzhong Sun
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  5. Yunhong Ma
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Contributions

Han XF, Cao ZH, Zhao K, Yin QD and MA YH reviewed the literature, collected, and analyzed the data and wrote the manuscript. Han XF provided pictures of clinical applications. Sun ZZ conducted biomechanical experiment. All authors read and approved the final 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

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 (Wuxi No.9 People’s Hospital, No. KT2021012; registration date: May 2021, retrospective registration), which abandoned the written consent of patients.

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Han, X., Cao, Z., Zhao, K. et al. Optimal insertion positions of anterior–posterior orientation sacroiliac screw. Eur Spine J 32, 1383–1392 (2023). https://doi.org/10.1007/s00586-023-07568-w

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  • DOI: https://doi.org/10.1007/s00586-023-07568-w

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