Direct Iliac Screw vs Sacral-2-Alar-Iliac Screws Technique for Sacropelvic Fixation: Technical Nuances and a Review of the Literature

Ahmed Habib; Nallammai Muthiah; Ali Alattar; Meagan Hoppe; Nitin Agarwal; Nima Alan; David Kojo Hamilton; Alp Ozpinar

doi:10.14444/8449

Direct Iliac Screw vs Sacral-2-Alar-Iliac Screws Technique for Sacropelvic Fixation: Technical Nuances and a Review of the Literature

Int J Spine Surg. 2023 Aug;17(4):511-519. doi: 10.14444/8449. Epub 2023 Apr 13.

Authors

Ahmed Habib^{1

2}, Nallammai Muthiah¹, Ali Alattar¹, Meagan Hoppe², Nitin Agarwal¹, Nima Alan¹, David Kojo Hamilton¹, Alp Ozpinar³

Affiliations

¹ Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, USA.
² Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, USA.
³ Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, USA ozpinar88@gmail.com.

PMID: 37055178
PMCID: PMC10478702
DOI: 10.14444/8449

Abstract

Sacropelvic (SP) fixation is the immobilization of the sacroiliac joint to attain lumbosacral fusion and prevent distal spinal junctional failure. SP fixation is indicated in numerous spinal conditions (eg, scoliosis, multilevel spondylolisthesis, spinal/sacral trauma, tumors, or infections). Many SP fixation techniques have been described in the literature. Currently, the most used surgical techniques for SP fixation are direct iliac screws and sacral-2-alar-iliac screws. There is currently no consensus in the literature on which technique carries more favorable clinical outcomes. In this review, we aim to assess the available data on each technique and discuss their respective advantages and disadvantages. We will also present our experience with a modification of direct iliac screws using a subcrestal approach and outline the future prospects of SP fixation.

Keywords: S2AI; fixation; iliac; sacropelvic; screw.

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