Insertion of percutaneous iliosacral screws with fluoroscopic guidance is associated with a relatively high screw malposition
rate and long radiation exposure. We asked whether radiation exposure was reduced and screw position improved in patients
having percutaneous iliosacral screw insertion using computer-assisted navigation compared with patients having conventional
fluoroscopic screw placement. We inserted 26 screws in 24 patients using the navigation system and 35 screws in 32 patients
using the conventional fluoroscopic technique. Two subgroups were analyzed, one in which only one iliosacral screw was placed
and another with additional use of an external fixator. We determined screw positions by computed tomography and compared
operation time, radiation exposure, and screw position. We observed no difference in operative times. Radiation exposure was
reduced for the patients and operating room personnel with computer assistance. The postoperative computed tomography scan
showed better screw position and fewer malpositioned screws in the three-dimensional navigated groups. Computer navigation
reduced malposition rate and radiation exposure.
Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his institution either has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.