In vivo minimally invasive reduction and fixation of sacroiliac luxation using a dedicated novel instrument system

OBJECTIVE: To evaluate the clinical safety and efficacy of a dedicated sacroiliac luxation instrument system (SILIS) featuring a minimally invasive lucent aiming device (MILAD) during osteosynthesis of sacroiliac luxation/fracture (SIL/F). We hypothesized that SILIS-MILAD assisted surgeries would be safe and as or more accurate than reported minimally invasive osteosynthesis (MIO) and open reduction and internal fixation (ORIF) techniques. STUDY DESIGN: Prospective, observational case series. ANIMALS: A total of 10 client owned dogs with traumatic SIL/F. METHODS: Dogs with SIL/F were treated using SILIS-MILAD assisted techniques. Outcome measures included shallow dose equivalent (SDE [mrem]), percent of reduction (PoR) and hemipelvic canal width ratio (HCWR), and sacral screw orientation angles in the transverse (dorsoventral angle, DVA) and dorsal (craniocaudal, CCA) planes. Data were reported as mean ± SD using descriptive statistics. RESULTS: A total of 10 dogs with 13 SIL/Fs were included. Mean patient SDE was ~122 mrem ± 55 mrem. In contrast, operating room (OR) personnel SDEs were negligible (~0.8 mrem ± 0.4 mrem). Mean PoR and HCWR were 95.6% ± 5.0% and 0.9 ± 0.2, respectively. Mean DVA and CCA were 1.1° ± 0.8° and 2.3° ± 1.8°, respectively. All patients were ambulatory when discharged. CONCLUSION: Clinical SILIS-MILAD assisted SIL/F fixation eliminated surgeon and OR personnel exposure to radiation and consistently provided near anatomical reduction and as or more accurate sacral screw placement than previously reported in ORIF and MIO studies. CLINICAL SIGNIFICANCE: This study demonstrates that SILIS-MILAD assisted surgeries can be safe and accurate and therefore provide a valid alternative to current open and minimally invasive techniques.