Takashi Hirase1,2, Caleb Shin3, Jeremiah Ling3, Brian Phelps4, Varan Haghshenas4, Comron Saifi4, Darrell S Hanson4. 1. Houston Methodist Orthopedics and Sports Medicine, 6445 Main Street, Suite 2500, Houston, TX, 77030, USA. thirase@houstonmethodist.org. 2. Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA. thirase@houstonmethodist.org. 3. Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA. 4. Houston Methodist Orthopedics and Sports Medicine, 6445 Main Street, Suite 2500, Houston, TX, 77030, USA.
Abstract
PURPOSE: To review and compare biomechanical properties between S2 alar-iliac (S2AI) screws and traditional iliac screws for spinopelvic fixation. METHODS: A systematic review was performed according to PRISMA guidelines. All clinical, cadaveric, and finite-element model (FEM) studies that compared the biomechanical properties between S2AI screws and traditional iliac screws were included. Study methodological quality for cadaveric studies were analyzed using the Quality Appraisal for Cadaveric Studies (QUACS) scale. RESULTS: Eight studies (4 cadaveric, 4 FEM) analyzing 58 S2AI screws and 48 traditional iliac screws were included. According to QUACS, the overall methodological quality was "moderate to good" for all four cadaveric studies. All four cadaveric studies found no difference in biomechanical stiffness, screw toggle, rod strain, and/or load-to-failure between the S2AI screws and traditional iliac screws for spinopelvic fixation. All four FEM studies found that S2AI screws were associated with lower implant stresses compared to traditional iliac screws. CONCLUSIONS: There is moderate biomechanical evidence to suggest that there is no significant difference in stability and stiffness between S2AI screws and traditional iliac screws for spinopelvic fixation. However, there is some evidence to support that the placement of S2AI screws may have lower implant stresses on the overall lumbosacral instrumentation compared to traditional iliac screws.
PURPOSE: To review and compare biomechanical properties between S2 alar-iliac (S2AI) screws and traditional iliac screws for spinopelvic fixation. METHODS: A systematic review was performed according to PRISMA guidelines. All clinical, cadaveric, and finite-element model (FEM) studies that compared the biomechanical properties between S2AI screws and traditional iliac screws were included. Study methodological quality for cadaveric studies were analyzed using the Quality Appraisal for Cadaveric Studies (QUACS) scale. RESULTS: Eight studies (4 cadaveric, 4 FEM) analyzing 58 S2AI screws and 48 traditional iliac screws were included. According to QUACS, the overall methodological quality was "moderate to good" for all four cadaveric studies. All four cadaveric studies found no difference in biomechanical stiffness, screw toggle, rod strain, and/or load-to-failure between the S2AI screws and traditional iliac screws for spinopelvic fixation. All four FEM studies found that S2AI screws were associated with lower implant stresses compared to traditional iliac screws. CONCLUSIONS: There is moderate biomechanical evidence to suggest that there is no significant difference in stability and stiffness between S2AI screws and traditional iliac screws for spinopelvic fixation. However, there is some evidence to support that the placement of S2AI screws may have lower implant stresses on the overall lumbosacral instrumentation compared to traditional iliac screws.
Authors: Joshua D Harris; Carmen E Quatman; M M Manring; Robert A Siston; David C Flanigan Journal: Am J Sports Med Date: 2013-08-07 Impact factor: 6.202
Authors: Lior Shabtai; Lindsay M Andras; Mark Portman; Liam R Harris; Paul D Choi; Vernon T Tolo; David L Skaggs Journal: J Pediatr Orthop Date: 2017-12 Impact factor: 2.324
Authors: Wataru Ishida; Seba Ramhmdani; Joshua Casaos; Alexander Perdomo-Pantoja; Benjamin D Elder; Nicholas Theodore; Ziya L Gokaslan; Jean-Paul Wolinsky; Daniel M Sciubba; Ali Bydon; Timothy F Witham; Sheng-Fu L Lo Journal: Clin Spine Surg Date: 2019-05 Impact factor: 1.876