Perspective Chapter: Sacral Alar Iliac Screws

Abstract

Often during the reconstruction of Adult and Pediatric Spinal Deformities pedicle screw fixation is insufficient and a distal anchor with pelvic fixation is of paramount importance. Various techniques regarding the methodologies of Spinopelvic fixation (SPF) and placement of Sacral-1 Alar Iliac (S1AI) and Sacral-2 Alar Iliac (S2AI) screws has been described in the literature. While there is some consensus among the various techniques and angles utilized, these are often difficult to reproduce in an operative setting. Recently navigation systems have allowed for the successful navigation of the Sacro Alar Iliac corridor without screw complications, however not every facility has this technology on hand. Therefore, proficiency with the safe and accurate placement of Sacroalar iliac (SAI) screws using standard fluoroscopic imaging becomes a vital technique when circumstances demand ample distal fixation. To our knowledge, a definitive step by step review of the sacroalar iliac technique warrants description in order to delineate the insertion point and exact fluoroscopic imaging which can help confirm the safe placement of SAI screws through the anatomical corridor.