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Minimally invasive lag screw fixation of sacroiliac luxation/fracture using a dedicated novel instrument system: Apparatus and technique description
Author(s) -
Déjardin Loïc M.,
Fauron Albane H.,
Guiot Laurent P.,
Guillou Reunan P.
Publication year - 2018
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.12746
Subject(s) - medicine , fluoroscopy , sacroiliac joint , cadaveric spasm , fixation (population genetics) , reduction (mathematics) , radiation exposure , osteosynthesis , orthodontics , cadaver , surgery , nuclear medicine , population , geometry , environmental health , mathematics
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.