Original Article

PERCUTANEOUS ILIOSACRAL SCREW PLACEMENT FOR SACRAL FRACTURES

  • Ali Akın UĞRAŞ
  • Murat YILMAZ
  • Nurullah ŞENER
  • Musa KORKMAZ
  • Ercan ÇETİNUS

J Turk Spinal Surg 2011;22(4):285-292

Objective:

The purpose of the study was to determine the effectiveness of percutaneous iliosacral screw for sacral fractures that cause pelvic instability.

Materials and methods:

10 patients with sacral fractures were retrospectively assessed. The study consists of 7 males and 3 females, the mean age was 29.1 ± 6.6. Neurologic injury was assessed according to Gibbons classification; fractures were classified according to Denis, Young and Burgess Classification. Clinical (Majeed score) and radiologic (Nelson ve Duwelius criteria) were used to analyze the patients.

Results:

Mean follow-up time was 14.3 ± 6.3 months. 2 patients had U-type sacral fractures, two patients had A2 fractures whereas other patients had A1, A3, B3 and C fractures. Totally sixteen screws were inserted including 6 bilaterally and 4 unilaterally inserted screws. One case received sacral laminectomy. The mean postoperative Majeed score was 73.6 ± 21.7, the mean radiographic displacement was found less than 5 mm in 90 % of patients and was found 5-10 mm in 10 % of patients. The mean vertical reduction was found less than 5mm. The mean Gibbons score was decreased from 2 ± 1.3 to 1.75 ± 1.4 after the operation. There was no iatrogenic nerve injury.

Conclusion:

Percutaneous iliosacral screw fixation is an effective way to obtain early pelvic stability and decreasing morbidity in sacral fracture cases with additional organ injuries and fractures.

Keywords: Sacral fracture, surgical treatment, percutaneous iliosacral screw