A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population

Study Design A retrospective computed tomography (CT)-based radiological analysis. Purpose To obtain CT-based morphometric data for the S2 alar iliac (S2AI) screw in the Indian population presenting to School of Medical Sciences and Research, Greater Noida, we used the concept of “safe trajectory” b...

Full description

Bibliographic Details
Main Authors: Rahul Kaul, Bharat Goswami, Khemendra Kumar, Madhan Jeyaraman, Gururaj Sangondimath, HS Chhabra
Format: Article
Language:English
Published: Korean Spine Society 2023-02-01
Series:Asian Spine Journal
Subjects:
Online Access:http://www.asianspinejournal.org/upload/pdf/asj-2022-0034.pdf
_version_ 1827956091417264128
author Rahul Kaul
Bharat Goswami
Khemendra Kumar
Madhan Jeyaraman
Gururaj Sangondimath
HS Chhabra
author_facet Rahul Kaul
Bharat Goswami
Khemendra Kumar
Madhan Jeyaraman
Gururaj Sangondimath
HS Chhabra
author_sort Rahul Kaul
collection DOAJ
description Study Design A retrospective computed tomography (CT)-based radiological analysis. Purpose To obtain CT-based morphometric data for the S2 alar iliac (S2AI) screw in the Indian population presenting to School of Medical Sciences and Research, Greater Noida, we used the concept of “safe trajectory” by Pontes and his colleagues in a recent study. Overview of Literature Although previous CT-based morphometric studies on the S2AI screw have been published for a variety of ethnic groups, morphometric data specifically for the Indian population are scarce. Methods We used the three-dimensional multiplanar reformatting software to conduct a retrospective CT analysis of 112 consecutive patients who met our exclusion criteria for various abdominal and pelvic pathologies. CT imaging planes were rotated between the S1 and S2 foramen until they matched the ideal S2AI screw trajectory, which was represented by the longest and widest iliac osseous channel observed in the axial CT section. Following the concept of a safe trajectory, S2AI screw morphometric parameters were measured on both sides of the pelvis using corresponding axial and sagittal CT images. Results In the sagittal and transverse planes on both sides of the pelvis, females had significantly higher screw trajectory angulation than males (p<0.001). On both sides of the pelvis, males had significantly greater iliac width, maximum screw trajectory length, and intrascrotal length than females (p<0.001). On both sides of the pelvis, the S2AI screw entry point in females was significantly deeper than in males from the skin margin (p<0.001). Conclusions Based on our methodology, we discovered that the S2AI screw trajectory is significantly more caudal and lateral in females, the maximum screw length is sufficient for use in clinical practice regardless of gender, and that 8.5 mm or even larger screw diameters are feasible in the majority of the Indian population.
first_indexed 2024-04-09T14:59:04Z
format Article
id doaj.art-dc23cf368e374ed0b749cfe4be752317
institution Directory Open Access Journal
issn 1976-1902
1976-7846
language English
last_indexed 2024-04-09T14:59:04Z
publishDate 2023-02-01
publisher Korean Spine Society
record_format Article
series Asian Spine Journal
spelling doaj.art-dc23cf368e374ed0b749cfe4be7523172023-05-01T23:47:38ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-02-0117113013710.31616/asj.2022.00341447A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian PopulationRahul Kaul0Bharat Goswami1Khemendra Kumar2Madhan Jeyaraman3Gururaj Sangondimath4HS Chhabra5 Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, India Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, India Department of Radio Diagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida, India Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, India Department of Spine Services, Indian Spinal Injuries Centre, New Delhi, India Department of Spine Services, Indian Spinal Injuries Centre, New Delhi, IndiaStudy Design A retrospective computed tomography (CT)-based radiological analysis. Purpose To obtain CT-based morphometric data for the S2 alar iliac (S2AI) screw in the Indian population presenting to School of Medical Sciences and Research, Greater Noida, we used the concept of “safe trajectory” by Pontes and his colleagues in a recent study. Overview of Literature Although previous CT-based morphometric studies on the S2AI screw have been published for a variety of ethnic groups, morphometric data specifically for the Indian population are scarce. Methods We used the three-dimensional multiplanar reformatting software to conduct a retrospective CT analysis of 112 consecutive patients who met our exclusion criteria for various abdominal and pelvic pathologies. CT imaging planes were rotated between the S1 and S2 foramen until they matched the ideal S2AI screw trajectory, which was represented by the longest and widest iliac osseous channel observed in the axial CT section. Following the concept of a safe trajectory, S2AI screw morphometric parameters were measured on both sides of the pelvis using corresponding axial and sagittal CT images. Results In the sagittal and transverse planes on both sides of the pelvis, females had significantly higher screw trajectory angulation than males (p<0.001). On both sides of the pelvis, males had significantly greater iliac width, maximum screw trajectory length, and intrascrotal length than females (p<0.001). On both sides of the pelvis, the S2AI screw entry point in females was significantly deeper than in males from the skin margin (p<0.001). Conclusions Based on our methodology, we discovered that the S2AI screw trajectory is significantly more caudal and lateral in females, the maximum screw length is sufficient for use in clinical practice regardless of gender, and that 8.5 mm or even larger screw diameters are feasible in the majority of the Indian population.http://www.asianspinejournal.org/upload/pdf/asj-2022-0034.pdfs2 alar iliac screwindian populationsafe trajectorycomputed tomography
spellingShingle Rahul Kaul
Bharat Goswami
Khemendra Kumar
Madhan Jeyaraman
Gururaj Sangondimath
HS Chhabra
A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
Asian Spine Journal
s2 alar iliac screw
indian population
safe trajectory
computed tomography
title A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
title_full A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
title_fullStr A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
title_full_unstemmed A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
title_short A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population
title_sort computed tomography based assessment of the anatomical parameters concerning s2 alar iliac screw insertion using safe trajectory method in indian population
topic s2 alar iliac screw
indian population
safe trajectory
computed tomography
url http://www.asianspinejournal.org/upload/pdf/asj-2022-0034.pdf
work_keys_str_mv AT rahulkaul acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT bharatgoswami acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT khemendrakumar acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT madhanjeyaraman acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT gururajsangondimath acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT hschhabra acomputedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT rahulkaul computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT bharatgoswami computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT khemendrakumar computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT madhanjeyaraman computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT gururajsangondimath computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation
AT hschhabra computedtomographybasedassessmentoftheanatomicalparametersconcernings2alariliacscrewinsertionusingsafetrajectorymethodinindianpopulation