3D CT modeling demonstrates the anatomic feasibility of S1AI screw trajectory for spinopelvic fixation in neuromuscular scoliosis.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2024-07-01 Epub Date: 2024-05-11 DOI:10.1007/s43390-024-00840-z

Xochitl M Bryson, Nicole S Pham, Ian Hollyer, Serena Hu, Lawrence A Rinsky, John S Vorhies

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引用次数: 0

Abstract

Purpose: In patients with neuromuscular scoliosis undergoing posterior spinal fusion, the S2 alar iliac (S2AI) screw trajectory is a safe and effective method of lumbopelvic fixation but can lead to implant prominence. Here we use 3D CT modeling to demonstrate the anatomic feasibility of the S1 alar iliac screw (S1AI) compared to the S2AI trajectory in patients with neuromuscular scoliosis.

Methods: This retrospective study used CT scans of 14 patients with spinal deformity to create 3D spinal reconstructions and model the insertional anatomy, max length, screw diameter, and potential for implant prominence between 28 S2AI and 28 S1AI screw trajectories.

Results: Patients had a mean age of 14.42 (range 8-21), coronal cobb angle of 85° (range 54-141), and pelvic obliquity of 28° (range 4-51). The maximum length and diameter of both screw trajectories were similar. S1AI screws were, on average, 6.3 ± 5 mm less prominent than S2AI screws relative to the iliac crests. S2AI screws were feasible in all patients, while in two patients, posterior elements of the lumbar spine would interfere with S1AI screw insertion.

Conclusion: In this cohort of patients with neuromuscular scoliosis, we demonstrate that the S1AI trajectory offers comparable screw length and diameter to an S2AI screw with less implant prominence. An S1AI screw, however, may not be feasible in some patients due to interference from the posterior elements of the lumbar spine.

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三维 CT 建模展示了 S1AI 螺钉轨迹用于神经肌肉性脊柱侧凸脊柱固定的解剖可行性。

目的：在接受脊柱后路融合术的神经肌肉性脊柱侧凸患者中，S2髂骨心螺钉（S2AI）轨迹是一种安全有效的腰椎骨盆固定方法，但可能导致植入物突出。在此，我们使用三维 CT 建模来证明 S1髂骨螺钉（S1AI）与 S2AI 轨迹相比，在神经肌肉性脊柱侧凸患者中的解剖学可行性：这项回顾性研究利用14例脊柱畸形患者的CT扫描创建了三维脊柱重建，并对28种S2AI和28种S1AI螺钉轨迹的插入解剖、最大长度、螺钉直径和植入突出的可能性进行了建模：患者的平均年龄为 14.42 岁（8-21 岁不等），冠状面钴角为 85°（54-141°不等），骨盆倾斜度为 28°（4-51°不等）。两种螺钉轨迹的最大长度和直径相似。相对于髂嵴，S1AI螺钉平均比S2AI螺钉突出6.3 ± 5 mm。所有患者都可以使用S2AI螺钉，但有两名患者的腰椎后部会影响S1AI螺钉的插入：结论：在这批神经肌肉性脊柱侧凸患者中，我们证明S1AI轨迹的螺钉长度和直径与S2AI螺钉相当，但植入物突出较少。然而，由于腰椎后部的干扰，S1AI螺钉在某些患者身上可能并不可行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.