BACKGROUND: Despite recent popularity of sacral alar iliac (SAI) screws for fusion to the pelvis for @entity4094 , there are little data regarding the failure rate of this technique compared with traditional modes of iliac fixation. Theoretical advantages of the SAI screws are obviating the need for a rod to iliac screw connector and a lower implant profile. The purpose of this study is to determine whether SAI screws have fewer failures than iliac screws in @entity4094 . METHODS: Review of neuromuscular @entity1 treated with posterior spinal fusion with pelvic fixation from 2004 to 2012 with minimum 2-year follow-up was conducted. Medical records and imaging studies were reviewed. @entity1 were divided into 2 groups based on the type of pelvic fixation (SAI or iliac screws), and implant failures were compared between the groups. RESULTS: A total of 101 @entity1 were reviewed, including 55 @entity1 with iliac screws and 46 @entity1 with SAI screws. Implant failures included: disengagement of the rod to iliac screw connector (10%, 10/101), separation of screw head from screw shaft (4%, 4/101), and set screw disengagement (2%, 2/101). The SAI group had a lower implant failure rate (7%, 3/46) compared with the iliac screw group (24%, 13/55) (P=0.031). Rod to iliac screw connectors failed in 18% (10/55) of @entity1 . There were significantly less surgical revisions in the SAI group (2%, 1/46) for pelvic screw prominence compared with the iliac screw group (11%, 6/55) (P=0.027). CONCLUSIONS: SAI screws had a lower rate of implant failure and revision surgery compared with iliac screws. If rod to screw connector failures are excluded, the failure rate of SAI screws of 6.5% (3/46) is similar to that of iliac screws 5.5% (3/55); therefore, the most important advantage of the SAI technique may be obviating the need for a screw to rod connector. LEVEL OF EVIDENCE: Level III.

Sacral Alar Iliac (SAI) Screws Fail 75% Less Frequently Than Iliac Screws in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Patients'] @entity4094 :: ('MESH:D009468', 'Disease') :: ['neuromuscular scoliosis']
@entity4094 :: (MESH:D009468,Disease) :: ['Neuromuscular Scoliosis']
