Abstract

RIZZI, Pablo et al. Lumbopelvic fixation with screws in adult patients. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2013, vol.78, n.1. ISSN 1852-7434.

Background: To achieve a solid fusion at L5-S1 is always more difficult than at other levels of the lumbar or thoracic spine. Fixation with screws to the iliac wings represents an alternative within the various methods of fixation. Objective: To evaluate the results of pelvic fixation with screws in adult patients without gait problems, specially considering the fixation in 4 points below L5. Methods: Twenty-five patients followed for at least 12 months. Predominant diagnosis: scoliosis, pseudoarthrosis. Results: Twenty-nine patients with several diseases underwent pelvic screw fixation. Results were evaluated by clinical assessment (VAS and Oswestry scale) and radiographic control. Results were as follows: preoperative VAS 7.8% and postoperative VAS 3.1%. The iliac postoperative pain in the VAS was 3.3%. Preoperative Oswestry scale was 74.4%, while the average postoperative percentage was 31.5%. Four patients required implant removal, all determined radiographically by radiolucent iliac screws. Rupture occurred in both iliac screws in 2 cases, and fusion was achieved in the remaining 24 cases. Conclusions: The pelvic screw fixation in long mergers is not free of complications, but it is an effective method to achieve a high rate of lumbosacral fusion in particularly complex cases by the length of the merger or the failure of previous surgery; it is a simple technique with a moderate rate of pelvic pain not only in the number of patients, but also in pain intensity, which was evidenced by the low number of patients who were reoperated on for removal of the screws.

Keywords : Pelvic fixation; Arthrodesis; Fusion lumbosacral; Pelvic screws.

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