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Minerva Ortopedica e Traumatologica 2019 September;70(3):153-8

DOI: 10.23736/S0394-3410.19.03930-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The freehand technique for S2-alar-iliac screw placement: a review of current literature in adult spinal deformity

Lauren M. NELSON 1 , Joseph L. LARATTA 2, Jamal N. SHILLINGFORD 2

1 Department of Orthopedic Surgery, University of Louisville, Louisville, KY, USA; 2 Department of Orthopedic Surgery, Norton Leatherman Spine Center, University of Louisville, Louisville, KY, USA



INTRODUCTION: S2AI screws have gained popularity as a means of achieving spinopelvic fixation. Traditionally, S2AI screws have been placed under fluoroscopic guidance, but recent studies have advocated the use of a freehand technique to reduce intraoperative radiation exposure to both the patient and the surgical team. The aim of this study was to determine the safety and effectiveness of the freehand technique for S2AI screw placement.
EVIDENCE ACQUISITION: Four databases were queried and the results were screened by title and abstract.
EVIDENCE SYNTHESIS: The majority of data on the freehand technique for S2AI screw placement comes from retrospective studies at this time. These studies have found low rates of cortical violations and no reported cases of neurovascular or visceral complications as a result of S2AI screw placement.
CONCLUSIONS: Though further studies are warranted, early data on the freehand technique for S2AI screw placement seems to suggest that it is a safe and effective method for placing S2AI screws with comparable outcomes to other methods of S2AI screw insertion.


KEY WORDS: Spine; Sacrum; Instrumentation

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