Iliosacral Screw Fixation of the Posterior Pelvic Ring Using Local Anesthesia and Computerized Tomography

Choy, Won Sik; Kim, Byung Sung; Kim, Ha Yong; Ahn, Jae Hoon; Jung, Yu Hun

Abstract

PURPOSE
To analyze the functional and radiological results after a CT-guided iliosacral screw fixation of the posterior pelvic ring using local anesthesia. MATERIALS AND METHODS: Nine patients with unstable pelvic ring injuries treated by CT-guided percutaneous iliosacral screw fixation under local anesthesia were enrolled in this study. Anterior lesion including 4 cases of symphysis pubis separation and 3 cases of displaced pubic ramus fracture was stabilized using a plate and screw before the posterior iliosacral screw fixation. The Iowa pelvic score was used for a functional evaluation. A reduction of the sacroiliac joint gap was analyzed using plain radiographs and CT. RESULTS: The mean follow-up period was 25 months (12-48) and the mean Iowa pelvic score was 84. The mean number of screws introduced was 1.55 and the mean time for the procedure was 24 minutes per screw. There were no neurovascular complications related to misplaced screws encroaching the spinal canal or neural foramen. The iliosacral joint separation was 8.2 mm preoperatively and 3.6 mm postoperatively. There was no screw loosening or breakage. CONCLUSION: Iliosacral screw fixation using local anesthesia and computerized tomography is an easyand safe procedure for the patients with unstable pelvic ring injuries.