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vol.17 issue4VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROMETOMOGRAPHIC STUDY OF THE S2-ALAR-ILIAC SCREW TECHNIQUE IN BRAZILIAN WOMEN author indexsubject indexarticles search
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Coluna/Columna

Print version ISSN 1808-1851On-line version ISSN 2177-014X

Abstract

ACCHAR, Marcos Calixto et al. EVALUATION OF THE RESULTS OF PELVIC FIXATION IN LONG LUMBOSACRAL INSTRUMENTATIONS IN ELDERLY PATIENTS. Coluna/Columna [online]. 2018, vol.17, n.4, pp.308-312. ISSN 2177-014X.  http://dx.doi.org/10.1590/s1808-185120181704162857.

Objective:

Evaluate the initial results and the possible complications of the combination of pelvic fixation using iliac screws in long instrumentations of the lumbar spine in elderly patients.

Methods:

An analysis of 38 patients who underwent lumbar spine arthrodesis instrumentation with more than 3 levels, in which we included level L5-S1 and extended the fixation to the iliac crest. Radiological assessment of instrumentation through X-ray of the lumbar spine and pelvis, and computed tomography, to investigate the presence of radiological fusion. Clinical evaluation through a questionnaire of buttock pain including the visual analogue pain score (VAS). Complications related to pelvic instrumentation were investigated.

Results:

All patients had radiological fusion in the lumbosacral transition. A halo was found around the iliac screw on imaging studies in 31% of patients, but without related symptoms. The questionnaire of buttock pain found that 15% of patients had some low intensity buttock pain (VAS 1-2) and no need to or interest in removing the screws. There was infection at the surgical site in 2% of cases, hematoma in the buttocks in 5%, and vertebral body fracture in the cranial level instrumented in 7% of cases.

Conclusions:

Pelvic fixation through the iliac screws proved to be effective in protecting the S1 screws in long instrumentations including the L5-S1 level in elderly patients, allowing the radiological bone fusion. The overall results for pain were satisfactory, based on a questionnaire of buttock pain. There are no signs of overload or degeneration of the sacroiliac joints in the early years after surgery. Level of Evidence IV; Case series - therapeutic study.

Keywords : Arthrodesis; Ilium; Outcome assessment; Lumbosacral region.

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