Article Abstract

Obstructed spinopelvic fixation in the setting of a triangular titanium sacroiliac fusion implant: a case description

Authors: Joseph L. Laratta, James D. Lin, Jamal N. Shillingford, Nathan E. Hardy, Hemant Reddy, Ronald A. Lehman

Abstract

Achieving lumbosacral fusion through spinopelvic fixation is an important and challenging aspect of spinal deformity surgery. Numerous instrumentation techniques are available, with iliac screws and S2-alar-iliac (SRAI) screws being most commonly used today. However, the increasing popularity of minimally invasive sacroiliac (SI) fusion as a common procedure performed for SI joint pain presents a distinct challenge in complex adult deformity cases requiring iliac screw fixation. We report a case of a 71-year-old female with a longstanding history of spinal deformity status-post T11–L5 fusion and a subsequent right-sided SI joint fusion who presented with sagittal imbalance. The SI joint fusion implant obstructed the pathway for spinopelvic fixation. Spinopelvic fixation was achieved by burring a pathway through the SI joint implant. The increasing popularity of minimally invasive SI fusion as a common procedure performed for SI joint pain presents a distinct challenge in complex adult deformity cases requiring iliac screw fixation. This is the first report in the literature describing a technique for spinopelvic fixation in the setting of screw obstruction due to an instrumented SI joint.

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