中国修复重建外科杂志

中国修复重建外科杂志

经 S2 骶髂螺钉技术在脊柱骨盆稳定性重建中应用的研究进展

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目的 总结近年来经 S2 骶髂(second sacral alar-iliac,S2AI)螺钉技术用于脊柱骨盆稳定性重建方面的研究进展。 方法 查阅近年国内外关于 S2AI 螺钉技术应用于脊柱骨盆稳定性重建方面的研究报道,对 S2AI 螺钉技术的发展历程、临床应用及其相关的解剖学、影像学及生物力学等方面进行分析总结。 结果 S2AI 螺钉技术作为一种新的临床脊柱骨盆稳定性重建方式,不仅取得令人满意的腰骶间稳定效果,同时也克服了传统髂骨螺钉钉尾端突出皮肤等相关并发症的问题。由于 S2AI 螺钉的钉道更加狭窄,所以增加了徒手植钉操作上的难度。虽然 S2AI 螺钉是穿透 3 层皮质固定,但生物力学试验结果显示,传统髂骨螺钉与 S2AI 螺钉在固定骶髂关节稳定性力学性能上无明显差异。 结论 在脊柱骨盆稳定性重建上,S2AI 螺钉技术可作为一种替代传统髂骨螺钉技术的相对安全可靠的选择。

Objective To summarize the current research progress of second sacral alar-iliac (S2AI) screw technique for reconstruction of spinopelvic stability. Methods The recent original literature concerning development, clinical applications, anatomy, imageology, and biomechanics of S2AI screw technique in reconstruction of spinopelvic stability was reviewed and analyzed. Results As a common clinical strategy for the reconstruction of spinopelvic stability, S2AI screws achieve satisfactory effectiveness of lumbosacral fixation without complications which were found during the application of traditional iliac screws technique. S2AI screw technique is more difficult to place screws by hand because of its narrow screw trajectory. Although the S2AI screws trajectory pass through 3 layers of bone cortex, the biomechanical cadaveric study demonstrate that no statistical difference in stiffness was found between the traditional iliac and S2AI screw in a spinopelvic fixation model. Conclusion S2AI screw technique should be a safe and feasible method for reconstruction of spinopelvic stability in place of the traditional iliac screw technique.

关键词: 经 S2 骶髂螺钉; 脊柱骨盆稳定性重建; 内固定; 髂骨螺钉

Key words: Second sacral alar-iliac screw; reconstruction of spinopelvic stability; internal fixation; iliac screw

引用本文: 张楠威, 于滨生. 经 S2 骶髂螺钉技术在脊柱骨盆稳定性重建中应用的研究进展 . 中国修复重建外科杂志, 2018, 32(6): 764-768. doi: 10.7507/1002-1892.201711124 复制

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1. Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg (Am), 2006, 88(4): 721-728.
2. Bridwell KH, Edwards CC 2nd, Lenke LG. The pros and cons to saving the L5-S1 motion segment in a long scoliosis fusion construct. Spine (Phila Pa 1976), 2003, 28(20): S234-242.
3. Emami A, Deviren V, Berven S, et al. Outcome and complications of long fusions to the sacrum in adult spine deformity: luque-galveston, combined iliac and sacral screws, and sacral fixation. Spine (Phila Pa 1976), 2002, 27(7): 776-786.
4. Chang TL, Sponseller PD, Kebaish KM, et al. Low profile pelvic fixation: anatomic parameters for sacral alar-iliac fixation versus traditional iliac fixation. Spine (Phila Pa 1976), 2009, 34(5): 436-440.
5. Yoshihara H. Rods in spinal surgery: a review of the literature. Spine J, 2013, 13(10): 1350-1358.
6. Jain A, Hassanzadeh H, Strike SA, et al. Pelvic fixation in adult and pediatric spine surgery: historical perspective, indications, and techniques: AAOS exhibit selection. J Bone Joint Surg (Am), 2015, 97(18): 1521-1528.
7. Shen FH, Mason JR, Shimer AL, et al. Pelvic fixation for adult scoliosis. Eur Spine J, 2013, 22 Suppl 2: S265-275.
8. Tis JE, Helgeson M, Lehman RA, et al. A biomechanical comparison of different types of lumbopelvic fixation. Spine (Phila Pa 1976), 2009, 34(24): E866-872.
9. Tumialán LM, Mummaneni PV. Long-segment spinal fixation using pelvic screws. Neurosurgery, 2008, 63(3 Suppl): 183-190.
10. Tsuchiya K, Bridwell KH, Kuklo TR, et al. Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity. Spine (Phila Pa 1976), 2006, 31(3): 303-308.
11. O’Brien JR, Yu WD, Bhatnagar R, et al. An anatomic study of the S2 iliac technique for lumbopelvic screw placement. Spine (Phila Pa 1976), 2009, 34(12): E439-442.
12. Zhu F, Bao HD, Yuan S, et al. Posterior second sacral alar iliac screw insertion: anatomic study in a Chinese population. Eur Spine J, 2013, 22(7): 1683-1689.
13. Wu AM, Chi YL, Ni WF, et al. The feasibility and radiological features of sacral alar iliac fixation in an adult population: a 3D imaging study. PeerJ, 2016, 4: e1587.
14. Sponseller PD, Zimmerman RM, Ko PS, et al. Low profile pelvic fixation with the sacral alar iliac technique in the pediatric population improves results at two-year minimum follow-up. Spine (Phila Pa 1976), 2010, 35(20): 1887-1892.
15. 刘臻, 邱勇, 胡宗杉, 等. 经第 2 骶椎骶髂螺钉固定技术在成人脊柱侧后凸畸形中的应用. 中华骨科杂志, 2016, 36(10): 584-590.
16. Park YS, Hyun SJ, Park JH, et al. Radiographic and clinical results of freehand S2 alar-iliac screw placement for spinopelvic fixation: an analysis of 45 consecutive screws. Clin Spine Surg, 2017, 30(7): E877-E882.
17. Mazur MD, Mahan MA, Shah LM, et al. Fate of S2-alar-iliac screws after 12-month minimum radiographic follow-up: preliminary results. Neurosurgery, 2017, 80(1): 67-72.
18. Ilyas H, Place H, Puryear A. A comparison of early clinical and radiographic complications of iliac screw fixation versus S2 alar iliac (S2AI) fixation in the adult and pediatric populations. J Spinal Disord Tech, 2015, 28(4): E199-205.
19. Mazur MD, Ravindra VM, Schmidt MH, et al. Unplanned reoperation after lumbopelvic fixation with S-2 alar-iliac screws or iliac bolts. J Neurosurg Spine, 2015, 23(1): 67-76.
20. Elder BD, Ishida W, Lo SL, et al. Use of S2-alar-iliac screws associated with less complications than iliac screws in adult lumbosacropelvic fixation. Spine (Phila Pa 1976), 2017, 42(3): E142-E149..
21. Ishida W, Elder BD, Holmes C, et al. Comparison between S2-alar-iliac screw fixation and iliac screw fixation in adult deformity surgery: reoperation rates and spinopelvic parameters. Global Spine J, 2017, 7(7): 672-680.
22. Lattig F, Weckbach S. S2-alar-iliac screws for extended pelvic fixation in longer lumbar instrumentations: Description of a freehand technique. Oper Orthop Traumatol, 2017, 29(4): 360-372.
23. 王孝宾, 王冰, 李晶, 等. 经骶 2 髂骨螺钉内固定在腰骶段结核稳定性重建中的应用. 中国脊柱脊髓杂志, 2017, 27(5): 392-398.
24. Funao H, Kebaish KM, Isogai N, et al. Utilization of a technique of percutaneous S2 alar-iliac fixation in immunocompromised patients with spondylodiscitis. World Neurosurg, 2017, 97: 757.e11-757.e18.
25. O’Brien JR, Matteini L, Yu WD, et al. Feasibility of minimally invasive sacropelvic fixation: percutaneous S2 alar iliac fixation. Spine (Phila Pa 1976), 2010, 35(4): 460-464.
26. Martin CT, Witham TF, Kebaish KM. Sacropelvic fixation: two case reports of a new percutaneous technique. Spine (Phila Pa 1976), 2011, 36(9): E618-621.
27. Nottmeier EW, Pirris SM, Balseiro S, et al. Three-dimensional image-guided placement of S2 alar screws to adjunct or salvage lumbosacral fixation. Spine J, 2010, 10(7): 595-601.
28. O’Brien JR, Yu W, Kaufman BE, et al. Biomechanical evaluation of S2 alar-iliac screws: effect of length and quad-cortical purchase as compared with iliac fixation. Spine (Phila Pa 1976), 2013, 38(20): E1250-1255.
29. Burns CB, Dua K, Trasolini NA, et al. Biomechanical comparison of spinopelvic fixation constructs: iliac screw versus S2-alar-iliac screw. Spine Deform, 2016, 4(1): 10-15.
30. Sutterlin CE 3rd, Field A, Ferrara LA, et al. Range of motion, sacral screw and rod strain in long posterior spinal constructs: a biomechanical comparison between S2 alar iliac screws with traditional fixation strategies. J Spine Surg, 2016, 2(4): 266-276.
31. Hoernschemeyer DG, Pashuck TD, Pfeiffer FM. Analysis of the s2 alar-iliac screw as compared with the traditional iliac screw: does it increase stability with sacroiliac fixation of the spine? Spine J, 2017, 17(6): 875-879.
32. Ishida W, Elder BD, Holmes C, et al. S2-alar-iliac screws are associated with lower rate of symptomatic screw prominence than iliac screws: radiographic analysis of minimal distance from screw head to skin. World Neurosurg, 2016, 93: 253-260.
33. Guler UO, Cetin E, Yaman O, et al. Sacropelvic fixation in adult spinal deformity (ASD); a very high rate of mechanical failure. Eur Spine J, 2015, 24(5): 1085-1091.