Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(06): 702-707
DOI: 10.1055/s-0040-1713163
Artigo Original
Coluna

Descrição do método de aferição dos parâmetros sacropélvicos para a inserção do parafuso S2-asa do ilíaco

Article in several languages: português | English
Mariana Demétrio de Sousa Pontes 
1   Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor System, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Lucas Klarosk Ismael 
1   Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor System, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Lucas Américo Francisco 
1   Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor System, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
,
Carlos Fernando Pereira da Silva Herrero 
1   Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor System, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Resumo

Objetivo Descrever como aferir os parâmetros sacropélvicos para a inserção segura do parafuso S2-asa do ilíaco (S2AI).

Métodos Estudo descritivo do método de aferição dos parâmetros sacropélvicos para a inserção do parafuso S2AI por meio de tomografia computadorizada (TC). Os dados avaliados em reconstruções multiplanares foram os parâmetros da trajetória do parafuso, incluindo comprimento, diâmetro e ângulos de trajetória nos planos axial e sagital.

Resultados A partir da reconstrução sagital, angula-se tridimensionalmente o eixo da série de cortes axiais de modo que seja possível visualizar a vértebra S2, o ponto de entrada do parafuso e a espinha ilíaca anteroinferior (EIAI) no mesmo plano. O ponto de entrada é demarcado no ponto médio entre os forames dorsais de S1 e S2. Para medir o comprimento do parafuso, traçam-se linhas tangenciando as corticais interna e externa do ilíaco. O diâmetro é determinado pela menor distância entre as tábuas interna e externa do ilíaco subtraindo metade do diâmetro do parafuso escolhido medialmente e lateralmente. O ângulo de trajetória no plano axial é formado pela linha média anteroposterior do sacro e a linha do comprimento do parafuso. O ângulo de inclinação craniocaudal em relação ao platô de S1 corresponde ao grau de inclinação feito no plano sagital para encontrar a imagem em que o ponto de entrada e a EIAI são vistos no mesmo plano.

Conclusão Foi possível aferir adequadamente, por meio de reconstruções multiplanares de TC, os parâmetros sacropélvicos necessários para a inserção segura do parafuso S2AI.

Palavras-chave

articulação sacroilíaca - coluna vertebral - sacro


Publication History

Received: 24 August 2019

Accepted: 20 February 2020

Article published online:
22 July 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 OʼBrien 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-E1255
    CrossrefPubMedGoogle Scholar
  • 2 Chang TL, Sponseller PD, Kebaish KM, Fishman EK. Low profile pelvic fixation: anatomic parameters for sacral alar-iliac fixation versus traditional iliac fixation. Spine (Phila Pa 1976) 2009; 34 (05) 436-440
    CrossrefPubMedGoogle Scholar
  • 3 Kwan MK, Jeffry A, Chan CYW, Saw LB. A radiological evaluation of the morphometry and safety of S1, S2 and S2-ilium screws in the Asian population using three dimensional computed tomography scan: an analysis of 180 pelvis. Surg Radiol Anat 2012; 34 (03) 217-227
    CrossrefPubMedGoogle Scholar
  • 4 O'Brien JR, Matteini L, Yu WD, Kebaish KM. Feasibility of minimally invasive sacropelvic fixation: percutaneous S2 alar iliac fixation. Spine (Phila Pa 1976) 2010; 35 (04) 460-464
    CrossrefPubMedGoogle Scholar
  • 5 Burns CB, Dua K, Trasolini NA, Komatsu DE, Barsi JM. Biomechanical Comparison of Spinopelvic Fixation Constructs: Iliac Screw Versus S2-Alar-Iliac Screw. Spine Deform 2016; 4 (01) 10-15
    CrossrefPubMedGoogle Scholar
  • 6 Matteini LE, Kebaish KM, Volk WR, Bergin PF, Yu WD, O'Brien JR. An S-2 alar iliac pelvic fixation. Technical note. Neurosurg Focus 2010; 28 (03) E13
    CrossrefPubMedGoogle Scholar
  • 7 Nottmeier EW, Pirris SM, Balseiro S, Fenton D. Three-dimensional image-guided placement of S2 alar screws to adjunct or salvage lumbosacral fixation. Spine J 2010; 10 (07) 595-601
    CrossrefPubMedGoogle Scholar
  • 8 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 (06) 875-879
    CrossrefPubMedGoogle Scholar
  • 9 Wu AM, Chen D, Chen CH. et al. The technique of S2-alar- iliac screw fixation: a literature review. AME Med J 2017; 2: 179
    CrossrefGoogle Scholar
  • 10 O'Brien JR, Yu WD, Bhatnagar R, Sponseller P, Kebaish KM. An anatomic study of the S2 iliac technique for lumbopelvic screw placement. Spine (Phila Pa 1976) 2009; 34 (12) E439-E442
    CrossrefPubMedGoogle Scholar
  • 11 Jost GF, Walti J, Mariani L, Cattin P. A novel approach to navigated implantation of S-2 alar iliac screws using inertial measurement units. J Neurosurg Spine 2016; 24 (03) 447-453
    CrossrefPubMedGoogle Scholar
  • 12 Kim YJ, Bridwell KH, Lenke LG, Cho KJ, Edwards II CC, Rinella AS. Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am 2006; 88 (04) 721-728
    PubMedGoogle Scholar
  • 13 Kebaish KM. Sacropelvic fixation: techniques and complications. Spine (Phila Pa 1976) 2010; 35 (25) 2245-2251
    CrossrefPubMedGoogle Scholar
  • 14 Emami A, Deviren V, Berven S, Smith JA, Hu SS, Bradford DS. 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 (07) 776-786
    CrossrefPubMedGoogle Scholar
  • 15 Edwards II CC, Bridwell KH, Patel A, Rinella AS, Berra A, Lenke LG. Long adult deformity fusions to L5 and the sacrum. A matched cohort analysis. Spine (Phila Pa 1976) 2004; 29 (18) 1996-2005
    CrossrefPubMedGoogle Scholar
  • 16 Klineberg E, McHenry T, Bellabarba C, Wagner T, Chapman J. Sacral insufficiency fractures caudal to instrumented posterior lumbosacral arthrodesis. Spine (Phila Pa 1976) 2008; 33 (16) 1806-1811
    CrossrefPubMedGoogle Scholar
  • 17 Leong JC, Lu WW, Zheng Y, Zhu Q, Zhong S. Comparison of the strengths of lumbosacral fixation achieved with techniques using one and two triangulated sacral screws. Spine (Phila Pa 1976) 1998; 23 (21) 2289-2294
    CrossrefPubMedGoogle Scholar
  • 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 (04) E199-E205
    CrossrefPubMedGoogle Scholar
  • 19 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 (03) E142-E149
    CrossrefPubMedGoogle Scholar
  • 20 Gupta S, Smith E, Falk D, O'Brien J. S2 alar-iliac screws versus iliac screws for pelvic fixation. AME Med J 2017; 2: 58
    CrossrefGoogle Scholar
  • 21 Ray WZ, Ravindra VM, Schmidt MH, Dailey AT. Stereotactic navigation with the O-arm for placement of S-2 alar iliac screws in pelvic lumbar fixation. J Neurosurg Spine 2013; 18 (05) 490-495
    CrossrefPubMedGoogle Scholar
  • 22 Hyun SJ, Kim KJ, Jahng TA. S2 alar iliac screw placement under robotic guidance for adult spinal deformity patients: technical note. Eur Spine J 2017; 26 (08) 2198-2203
    CrossrefPubMedGoogle Scholar
  • 23 El Dafrawy MH, Kebaish KM. Percutaneous S2 alar iliac fixation for pelvic insufficiency fracture. Orthopedics 2014; 37 (11) e1033-e1035
    CrossrefPubMedGoogle Scholar
  • 24 Bederman SS, Hahn P, Colin V, Kiester PD, Bhatia NN. Robotic Guidance for S2-Alar-Iliac Screws in Spinal Deformity Correction. Clin Spine Surg 2017; 30 (01) E49-E53
    CrossrefPubMedGoogle Scholar
  • 25 Mirkovic S, Abitbol JJ, Steinman J. et al. Anatomic consideration for sacral screw placement. Spine (Phila Pa 1976) 1991; 16 (6, Suppl) S289-S294
    CrossrefPubMedGoogle Scholar
  • 26 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 (07) 1683-1689
    CrossrefPubMedGoogle Scholar