CLINICAL AND RADIOLOGICAL COMPARISON OF SPINOPELVIC FIXATION METHODS: S2-ALAR-ILIAC SCREW VERSUS CONVENTIONAL ILIAC SCREW IN LONG SEGMENT FUSION

Özet

Objective: This study aimed to compare two different screw techniques used in spinopelvic instrumentation: the S2-alar-iliac (S2AI) method and the conventional iliac screw method, in terms of their radiographic parameters, health-related quality of life and associated complications. Materials and Methods: A total of 56 patients aged over 60 years, who underwent spinopelvic fixation using two different screw techniques, because of degenerative spinal diseases between 2012 and 2017 were retrospectively enrolled. They were divided into two groups based on the type of screw technique used; twenty-nine patients underwent the S2AI screw method (group 1) while 27 patients underwent the iliac screw method (group 2). Preoperative and postoperative radiographic parameters [sagittal vertical axis (SVA), sacral slope (SS), pelvic tilt (PT) and lumbar lordosis (LL)] and the Oswestry Disability index (ODI) were measured and compared. Results: Generally, all the radiographic parameters (SVA, SS, PT, LL) demonstrated a significant postoperative improvement in the whole study group; however, there were no significant differences between group 1 and group 2 (p=0.696, p=0.218, p=0.245, p=0.117). Regarding the ODI, a significant improvement was observed in all the patients in the postoperative period compared with the preoperative period, although no significant differences were detected between group 1 and group 2 (p=0.522). Overall, complications occurred in 32.1% (18/56) of patients: 24.1% (7/29) of patients in group 1 and 40.7% (11/27) of patients in group 2 (11/270), but no statistically significant difference was found. Conclusion: This study revealed that the two screw methods being compared have yielded similar results in terms of radiographic parameters and clinical outcomes. Therefore, we recommend that surgical teams should use the screw technique they are most experienced and familiar with