Minimally invasive lag screw fixation of sacroiliac luxation/fracture using a dedicated novel instrument system: Apparatus and technique description.

Autor: Déjardin LM; College of Veterinary Medicine, Michigan State University, East Lansing, Michigan., Fauron AH; College of Veterinary Medicine, Michigan State University, East Lansing, Michigan., Guiot LP; Bone & Joint Center, ACCESS Specialty Animal Hospitals, Los Angeles, California., Guillou RP; Bone & Joint Center, ACCESS Specialty Animal Hospitals, Los Angeles, California.
Jazyk: angličtina
Zdroj: Veterinary surgery : VS [Vet Surg] 2018 Jan; Vol. 47 (1), pp. 93-103. Date of Electronic Publication: 2017 Nov 29.
DOI: 10.1111/vsu.12746
Abstrakt: Objective: To describe a novel Sacroiliac Luxation Instrument System (SILIS™) and its application in minimally invasive osteosynthesis (MIO) of sacroiliac luxations/fractures (SIL/F). The SILIS was designed to provide stable SIL/F reduction and accurate sacral screw placement while reducing personnel exposure to ionizing radiation during intraoperative fluoroscopy.
Study Design: Descriptive, proof of concept cadaveric study.
Methods: A right SIL and a left SIL/F were created on a Labrador Retriever that had died of natural causes. Bilateral sacroiliac lag screw fixation was performed under fluoroscopic guidance with the SILIS, which consists of dedicated reduction and fixation instruments rigidly linked to table-bound 6-axis arms.
Results: Throughout surgery, the SILIS facilitated and maintained stable reduction and allowed accurate placement of a custom designed drill guide over the sacral body without the surgeon's manual holding of any reduction or fixation instruments. The surgical team was therefore able to step away from the C-arm when acquiring fluoroscopic images, thus reducing exposure to radiation. Dorsoventral and craniocaudal screw deviation from an ideal trajectory ranged from 0.9° to 3.8°. Both screws were fully located within the sacral body.
Conclusion: The SILIS addresses limitations associated with MIO of SIL/F, including maintenance of reduction throughout surgery along with reliable and accurate sacral screw placement. Distance from the X-ray source is the most effective protection against radiation. Use of the SILIS allows the surgical team to move away from the C-arm during fluoroscopy, thereby reducing personnel exposure to dangerous direct and back-scattered ionizing radiation.
(© 2017 The American College of Veterinary Surgeons.)
Databáze: MEDLINE
Externí odkaz: