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European Spine Journal

Published in:

01-07-2014 | Original Article

Intrasacral rod fixation for pediatric lumbopelvic fusion

Authors: Brice Ilharreborde, Keyvan Mazda

Published in: European Spine Journal | Special Issue 4/2014

Abstract

Purpose

This paper reports the authors’ 19 years experience with pediatric intrasacral rod fixation.

Methods

After insertion of two cannulated screws in S1 with and an original template guiding them into the anterior third of the endplate, two short fusion rods were inserted into the sacrum according to Jackson’s technique distally to S3. In neuromuscular scoliosis, pelvic obliquity was reduced by connecting the proximal and distal constructs, distraction or compression, and in situ rod bending. In children with high-grade spondylolisthesis, lumbosacral kyphosis was reduced by rotation of the sacrum and in situ bending.

Results

There were no direct neurological or vascular injuries. The main complication was infection (7 %). No pseudarthrosis or significant loss of correction at the lumbosacral junction was observed during follow-up.

Conclusions

Intrasacral rod fixation appears to be safe and reliable for lumbopelvic fusion in pediatric patients.

DeWald CJ, Vartabedian JE, Rodts MF, Hammerberg KW (2005) Evaluation and management of high-grade spondylolisthesis in adults. Spine (Phila Pa 1976) 30:S49–S59CrossRef

Lamartina C, Zavatsky JM, Petruzzi M, Specchia N (2009) Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J 18(Suppl 1):133–142PubMedCentralPubMedCrossRef

Allen BL Jr, Ferguson RL (1984) The Galveston technique of pelvic fixation with L-rod instrumentation of the spine. Spine (Phila Pa 1976) 9:388–394CrossRef

Bell DF, Moseley CF, Koreska J (1989) Unit rod segmental spinal instrumentation in the management of patients with progressive neuromuscular spinal deformity. Spine (Phila Pa 1976) 14:1301–1307CrossRef

McCarthy RE, Dunn H, McCullough FL (1989) Luque fixation to the sacral ala using the Dunn-McCarthy modification. Spine (Phila Pa 1976) 14:281–283CrossRef

Miladi LT, Ghanem IB, Draoui MM, Zeller RD, Dubousset JF (1997) Iliosacral screw fixation for pelvic obliquity in neuromuscular scoliosis. A long-term follow-up study. Spine (Phila Pa 1976) 22:1722–1729CrossRef

Moshirfar A, Rand FF, Sponseller PD, Parazin SJ, Khanna AJ, Kebaish KM, Stinson JT, Riley LH 3rd (2005) Pelvic fixation in spine surgery. Historical overview, indications, biomechanical relevance, and current techniques. J Bone Jt Surg Am 87(Suppl 2):89106

Peelle MW, Lenke LG, Bridwell KH, Sides B (2006) Comparison of pelvic fixation techniques in neuromuscular spinal deformity correction: galveston rod versus iliac and lumbosacral screws. Spine (Phila Pa 1976) 31:2392–2398 (discussion 2399)CrossRef

Pihlajamaki H, Myllynen P, Bostman O (1997) Complications of transpedicular lumbosacral fixation for non-traumatic disorders. J Bone Jt Surg Br 79:183–189CrossRef

10.

Zahi R, Thevenin-Lemoine C, Rogier A, Constantinou B, Mary P, Vialle R (2011) The “T-construct” for spinopelvic fixation in neuromuscular spinal deformities. Preliminary results of a prospective series of 15 patients. Childs Nerv Syst 27:1931–1935PubMedCrossRef

11.

Jackson RP, McManus AC (1993) The iliac buttress. A computed tomographic study of sacral anatomy. Spine (Phila Pa 1976) 18:1318–1328CrossRef

12.

Mazda K, Khairouni A, Pennecot GF, Bloch J (1998) The ideal position of sacral transpedicular endplate screws in Jackson’s intrasacral fixation. An anatomic study of 50 sacral specimens. Spine (Phila Pa 1976) 23:2123–2126CrossRef

13.

Ilharreborde B, Hoffmann E, Tavakoli S, Queinnec S, Fitoussi F, Presedo A, Pennecot GF, Mazda K (2009) Intrasacral rod fixation for pediatric long spinal fusion: results of a prospective study with a minimum 5-year follow-up. J Pediatr Orthop 29:594–601PubMedCrossRef

14.

Ilharreborde B, Fitoussi F, Morel E, Bensahel H, Pennecot GF, Mazda K (2007) Jackson’s intrasacral fixation in the management of high-grade isthmic spondylolisthesis. J Pediatr Orthop B 16:16–18PubMedCrossRef

15.

Deng YW, Qiu Y, Wang B (2002) Biomechanical comparative study of lumbosacral fixation and Jackson intrasacral fixation. Hunan Yi Ke Da Xue Xue Bao 27:495–498PubMed

16.

Glazer PA, Colliou O, Lotz JC, Bradford DS (1996) Biomechanical analysis of lumbosacral fixation. Spine (Phila Pa 1976) 21:1211–1222CrossRef

17.

Lebwohl NH, Cunningham BW, Dmitriev A, Shimamoto N, Gooch L, Devlin V, Boachie-Adjei O, Wagner TA (2002) Biomechanical comparison of lumbosacral fixation techniques in a calf spine model. Spine (Phila Pa 1976) 27:2312–2320CrossRef

18.

Nishiura T, Nishiguchi M, Kusaka N, Takayama K, Maeda Y, Ogihara K, Nakagawa M (2007) Usefulness of intrasacral fixation in an extremely unstable lumbosacral spine. No ShinkeiGeka 35:377–384

Title: Intrasacral rod fixation for pediatric lumbopelvic fusion
Authors: Brice Ilharreborde
Keyvan Mazda
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 4/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3344-5

At a glance: The STEP trials

Springer Medicine

Intrasacral rod fixation for pediatric lumbopelvic fusion

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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