Björn-Christian Link, R A Haveman, B J M Van de Wall, R Baumgärtner, R Babst, F J P Beeres, P C Haefeli
{"title":"Percutaneous sacroiliac screw fixation with a 3D robot-assisted image-guided navigation system : Technical solutions.","authors":"Björn-Christian Link, R A Haveman, B J M Van de Wall, R Baumgärtner, R Babst, F J P Beeres, P C Haefeli","doi":"10.1007/s00064-024-00871-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Presentation and description of percutaneous sacroiliac (SI) screw fixation with the use of a 3D robot-assisted image-guided navigation system and the clinical outcome of this technique.</p><p><strong>Indications: </strong>Pelvic fractures involving the posterior pelvis.</p><p><strong>Contraindications: </strong>Patients not suited for surgery.</p><p><strong>Surgical technique: </strong>Planning the screws on the diagnostic computer tomogram (CT). Matching with a low-dose CT in the operating room. Lateral incision. Verify the guidewire position with the personalized inlet and outlet views. After correct positioning, place a cannulated screw over the guidewire. For fragility fractures, augmentation is recommended. Finish the surgery with a final 3D scan to confirm correct placement of the screws and cement.</p><p><strong>Postoperative management: </strong>Direct postoperative mobilization with pain-adapted full weight-bearing.</p><p><strong>Results: </strong>Data of 141 patients between January 2018 and August 2022 were analyzed (average age 82 ± 10 years, 89% female). Most of the fractures were type II fragility fractures of the pelvis (FFP; 75%). The median hospital stay was 12 ± 7 days and the median surgery duration for a unilateral SI screw was 26 min. In total 221 S1 screws and 17 S2 screws were applied. No screws showed signs of loosening or migration. Of the five suboptimally placed screws, one screw was removed due to sensory impairment. All patients with cement leakage remained without symptoms.</p><p><strong>Conclusion: </strong>The surgical technique with the use of a 3D robot-assisted image-guided navigation system is a technique for safe fixation of dorsal fragility fractures of the pelvis and is associated with fewer complications.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"3-13"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790701/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Orthopadie Und Traumatologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00064-024-00871-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Presentation and description of percutaneous sacroiliac (SI) screw fixation with the use of a 3D robot-assisted image-guided navigation system and the clinical outcome of this technique.
Indications: Pelvic fractures involving the posterior pelvis.
Contraindications: Patients not suited for surgery.
Surgical technique: Planning the screws on the diagnostic computer tomogram (CT). Matching with a low-dose CT in the operating room. Lateral incision. Verify the guidewire position with the personalized inlet and outlet views. After correct positioning, place a cannulated screw over the guidewire. For fragility fractures, augmentation is recommended. Finish the surgery with a final 3D scan to confirm correct placement of the screws and cement.
Postoperative management: Direct postoperative mobilization with pain-adapted full weight-bearing.
Results: Data of 141 patients between January 2018 and August 2022 were analyzed (average age 82 ± 10 years, 89% female). Most of the fractures were type II fragility fractures of the pelvis (FFP; 75%). The median hospital stay was 12 ± 7 days and the median surgery duration for a unilateral SI screw was 26 min. In total 221 S1 screws and 17 S2 screws were applied. No screws showed signs of loosening or migration. Of the five suboptimally placed screws, one screw was removed due to sensory impairment. All patients with cement leakage remained without symptoms.
Conclusion: The surgical technique with the use of a 3D robot-assisted image-guided navigation system is a technique for safe fixation of dorsal fragility fractures of the pelvis and is associated with fewer complications.
目的：介绍和描述使用三维机器人辅助图像引导导航系统进行经皮骶髂关节（SI）螺钉固定的方法和临床效果：介绍和描述使用三维机器人辅助图像引导导航系统的经皮骶髂关节（SI）螺钉固定术以及该技术的临床效果：禁忌症：不适合手术的患者：禁忌症：不适合手术的患者：手术技术：在诊断性计算机断层扫描（CT）上规划螺钉。在手术室使用低剂量 CT 进行匹配。侧切口。通过个性化的入口和出口视图确认导丝位置。正确定位后，在导丝上放置插管螺钉。对于脆性骨折，建议进行扩孔。手术结束后进行最后的 3D 扫描，以确认螺钉和骨水泥的正确位置：术后管理：术后直接活动，疼痛时完全负重：分析了2018年1月至2022年8月期间141名患者的数据（平均年龄82±10岁，89%为女性）。大多数骨折为II型骨盆脆性骨折（FFP；75%）。住院时间中位数为12±7天，单侧SI螺钉手术时间中位数为26分钟。共使用了221枚S1螺钉和17枚S2螺钉。没有螺钉出现松动或移位迹象。在五枚放置不理想的螺钉中，一枚因感觉受损而被移除。所有出现骨水泥渗漏的患者均无症状：结论：使用三维机器人辅助图像引导导航系统的手术技术是一种安全固定骨盆背侧脆性骨折的技术，并发症较少。
期刊介绍：
Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care.
The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems.
Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
