Sacropelvic fixation: Two case reports of a new percutaneous technique

Study Design.: Case report. Objective.: To describe a new method of minimally invasive percutaneous sacropelvic fixation and to report on its use in two patients. SUMMARY OF BACKGROUND DATA.: The Galveston and iliac screw techniques are in widespread use for sacropelvic fixation, but neither technique is amenable to a percutaneous approach. The S2-alar-iliac technique is a recently described method that involves finding a pathway from the S2 sacrum into the ilium with fluoroscopy. We describe a new minimally invasive approach for this technique that allows percutaneous insertion of the screws and spinal construct. Methods.: A 69-year-old female with follicular thyroid carcinoma metastatic to the sacrum and a 55-year-old male with a sacral fracture were both treated with the new technique. We have described this new technique and reviewed the patients' clinical history, radiographic imaging, and outcomes. Results.: Stable fixation was achieved in both cases. Blood loss was 70 and 45 mL, respectively. There were no intraoperative complications. Conclusion.: To our knowledge, this report is the first description of a percutaneous minimally invasive approach to sacropelvic fixation in spinal fusion surgery. It is likely that this minimally invasive technique will result in less blood loss, lower infection rates, and a more rapid postoperative recovery than that associated with the more widely used open techniques.