C-arm fluoroscopy- navigated minimally invasive percutaneous screw in treatment of sacroiliac joint complex injury

Objective To study the C-arm fluoroscopy- navigated minimally invasive percutaneous screw in treatment of sacroiliac joint complex injury. Methods Twelve sacroiliac joint complex injury patients (9 males and 3 females) aged 19-67 years (mean 39 years) admitted to our hospital from October 2009 to August 2011 were included in this study. Of these patients, 3 were diagnosed as B2, 2 as B3, 5 as Cl and 2 as C2 according to the Tile classification system. The patients underwent C-arm fluoroscopy- navigated minimally invasive percutaneous screw. Their postoperative X-ray films were evaluated according to the Mears reduction standard and their postoperative function was scored following the Majeed criteria. Results A total of 16 screws were inserted in 12 patients.The average operation time was 42 min (ranging 29-97 min). The average blood loss was 8 ml (range 1-20 ml). The average fluoroscopy time was 3.3 min (range 1.4-6.1 min). The patients were followed up for 11-25 months. The postoperative pelvic X-ray and CT scan showed that the sacroiliac joint complex injury had a good reduction and all the screws were exactly positioned except for mild shift in 1 patient. No complications occurred, such as iatrogenic nerve and vascular injury. Postoperative mild sacroiliac pain and discomfort occurred in 2 patients when they leaved their sickbed and were relieved after drug treatment. Nine patients returned to their community. Anatomy reduction was achieved in 8 patients according to the Mears reduction standard. Of the 12 patients, 8 had an excellent outcome, 3 a good outcome, and 1 a fair outcome according to the Majeed function evaluation standards, with an excellent and good rate of 91.7%. Conclusion C-arm fluoroscopy- navigated minimally invasive percutaneous screw can increase the reduction accuracy of sacroiliac joint complex injury and reduce the incidence of postoperative complications, thus contributing to the early function recovery of patients.