{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:25:47Z","timestamp":1787239547304,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Foundation of the clinical trial","award":["2022-LCYJ-MS-22"],"award-info":[{"award-number":["2022-LCYJ-MS-22"]}]},{"name":"Jiangsu Provincial 333 talent plan","award":["(2022)3-1-238"],"award-info":[{"award-number":["(2022)3-1-238"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1007\/s00586-025-09011-8","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T11:39:40Z","timestamp":1749555580000},"page":"4102-4110","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Free-hand insertion of S2AI screw: what can we learn from O-arm navigation?"],"prefix":"10.1007","volume":"34","author":[{"given":"Changsheng","family":"Fan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bangheng","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongshan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zezhang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"issue":"9","key":"9011_CR1","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/j.molmed.2023.05.012","volume":"29","author":"E Petrosyan","year":"2023","unstructured":"Petrosyan E, Fares J, Lesniak MS et al (2023) Biological principles of adult degenerative scoliosis [J]. Trends Mol Med 29(9):740\u2013752","journal-title":"Trends Mol Med"},{"key":"9011_CR2","doi-asserted-by":"publisher","first-page":"100661","DOI":"10.1016\/j.inat.2019.100661","volume":"20","author":"A Kelly","year":"2020","unstructured":"Kelly A, Younus A, Lekgwara P (2020) Adult degenerative scoliosis\u2013 A literature review [J]. Interdisciplinary Neurosurg 20:100661","journal-title":"Interdisciplinary Neurosurg"},{"issue":"4","key":"9011_CR3","first-page":"721","volume":"88","author":"YJ Kim","year":"2006","unstructured":"Kim YJ, Bridwell KH, Lenke LG et al (2006) Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis [J]. J Bone Joint Surg Am 88(4):721\u2013728","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"9011_CR4","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1177\/21925682211009178","volume":"13","author":"YC Yao","year":"2023","unstructured":"Yao YC, Kim HJ, Bannwarth M et al (2023) Lowest instrumented vertebra selection to S1 or ilium versus L4 or L5 in adult spinal deformity: factors for consideration in 349 patients with a mean 46-Month Follow-Up [J]. Global Spine J 13(4):932\u2013939","journal-title":"Global Spine J"},{"issue":"8","key":"9011_CR5","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1007\/s00586-021-06864-7","volume":"30","author":"Z Gao","year":"2021","unstructured":"Gao Z, Sun X, Chen C et al (2021) Comparative radiological outcomes and complications of sacral-2-alar Iliac screw versus Iliac screw for sacropelvic fixation [J]. Eur Spine J 30(8):2257\u20132270","journal-title":"Eur Spine J"},{"issue":"4","key":"9011_CR6","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s00586-018-5806-7","volume":"28","author":"MCM Tavares Junior","year":"2019","unstructured":"Tavares Junior MCM, de Souza JPV, Araujo TPF et al (2019) Comparative tomographic study of the S2-alar-iliac screw versus the Iliac screw [J]. Eur Spine J 28(4):855\u2013862","journal-title":"Eur Spine J"},{"issue":"12","key":"9011_CR7","doi-asserted-by":"publisher","first-page":"E439","DOI":"10.1097\/BRS.0b013e3181a4e3e4","volume":"34","author":"JR O\u2019Brien","year":"2009","unstructured":"O\u2019Brien JR, Yu WD, Bhatnagar R et al (2009) An anatomic study of the S2 Iliac technique for lumbopelvic screw placement [J]. Spine (Phila Pa 1976) 34(12):E439\u2013E442","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2suppl","key":"9011_CR8","doi-asserted-by":"publisher","first-page":"45S","DOI":"10.1177\/21925682211036664","volume":"12","author":"A Arora","year":"2022","unstructured":"Arora A, Berven S (2022) Challenges and complications in freehand S2-Alar-Iliac spinopelvic fixation and the potential for robotics to enhance patient safety [J]. Global Spine J 12(2suppl):45S\u201352S","journal-title":"Global Spine J"},{"issue":"9","key":"9011_CR9","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1097\/00007632-199009000-00018","volume":"15","author":"JF Camp","year":"1990","unstructured":"Camp JF, Caudle R, Ashmun RD et al (1990) Immediate complications of Cotrel-Dubousset instrumentation to the sacro-pelvis. A clinical and Biomechanical study [J]. Spine (Phila Pa 1976) 15(9):932\u2013941","journal-title":"Spine (Phila Pa 1976)"},{"key":"9011_CR10","doi-asserted-by":"publisher","first-page":"e108","DOI":"10.1016\/j.wneu.2018.04.095","volume":"116","author":"A Abdul-Jabbar","year":"2018","unstructured":"Abdul-Jabbar A, Yilmaz E, Iwanaga J et al (2018) Neurovascular relationships of S2AI screw placement: anatomic study [J]. World Neurosurg 116:e108\u2013e12","journal-title":"World Neurosurg"},{"issue":"5","key":"9011_CR11","doi-asserted-by":"publisher","first-page":"490","DOI":"10.3171\/2013.2.SPINE12813","volume":"18","author":"WZ Ray","year":"2013","unstructured":"Ray WZ, Ravindra VM, Schmidt MH et al (2013) Stereotactic navigation with the O-arm for placement of S-2 Alar Iliac screws in pelvic lumbar fixation [J]. J Neurosurg Spine 18(5):490\u2013495","journal-title":"J Neurosurg Spine"},{"issue":"9","key":"9011_CR12","doi-asserted-by":"publisher","first-page":"3094","DOI":"10.1007\/s00586-023-07710-8","volume":"32","author":"C Li","year":"2023","unstructured":"Li C, Wang Z, Li D et al (2023) Safety and accuracy of cannulated pedicle screw placement in scoliosis surgery: a comparison of robotic-navigation, O-arm-based navigation, and freehand techniques [J]. Eur Spine J 32(9):3094\u20133104","journal-title":"Eur Spine J"},{"issue":"21","key":"9011_CR13","doi-asserted-by":"publisher","first-page":"E1297","DOI":"10.1097\/BRS.0000000000002694","volume":"43","author":"JN Shillingford","year":"2018","unstructured":"Shillingford JN, Laratta JL, Park PJ et al (2018) Human versus robot: A Propensity-Matched analysis of the accuracy of free hand versus robotic guidance for placement of S2 Alar-Iliac (S2AI) screws [J]. Spine (Phila Pa 1976) 43(21):E1297\u2013E304","journal-title":"Spine (Phila Pa 1976)"},{"key":"9011_CR14","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4103\/2152-7806.68705","volume":"1","author":"P Park","year":"2010","unstructured":"Park P, Foley KT, Cowan JA et al (2010) Minimally invasive pedicle screw fixation utilizing O-arm fluoroscopy with computer-assisted navigation: feasibility, technique, and preliminary results [J]. Surg Neurol Int 1:44","journal-title":"Surg Neurol Int"},{"issue":"4","key":"9011_CR15","doi-asserted-by":"publisher","first-page":"334","DOI":"10.2106\/JBJS.17.00052","volume":"100","author":"JN Shillingford","year":"2018","unstructured":"Shillingford JN, Laratta JL, Tan LA et al (2018) The Free-Hand technique for S2-Alar-Iliac screw placement: A safe and effective method for sacropelvic fixation in adult spinal deformity [J]. J Bone Joint Surg Am 100(4):334\u2013342","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"9011_CR16","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1007\/s00586-013-2734-4","volume":"22","author":"F Zhu","year":"2013","unstructured":"Zhu F, Bao HD, Yuan S et al (2013) Posterior second sacral Alar Iliac screw insertion: anatomic study in a Chinese population [J]. Eur Spine J 22(7):1683\u20131689","journal-title":"Eur Spine J"},{"issue":"3","key":"9011_CR17","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/2192568220903033","volume":"11","author":"Y Tatara","year":"2021","unstructured":"Tatara Y, Niimura T, Sekiya T et al (2021) Extra-articular portion of the sacroiliac Joint-Between the sacral and pelvic tuberosities: an anatomical guide for the S2-Alar-Iliac screw trajectory [J]. Global Spine J 11(3):305\u2013311","journal-title":"Global Spine J"},{"issue":"12","key":"9011_CR18","doi-asserted-by":"publisher","first-page":"1928","DOI":"10.1016\/j.spinee.2023.07.009","volume":"23","author":"K Masuda","year":"2023","unstructured":"Masuda K, Shigematsu H, Inoue D et al (2023) Assessment of two entry points for S2 alar-iliac screw in a Japanese cohort using three-dimensional computed tomography scan [J]. Spine J 23(12):1928\u20131934","journal-title":"Spine J"},{"issue":"6","key":"9011_CR19","doi-asserted-by":"publisher","first-page":"874","DOI":"10.31616\/asj.2021.0268","volume":"16","author":"N Watanabe","year":"2022","unstructured":"Watanabe N, Takigawa T, Uotani K et al (2022) Three-Dimensional analysis of the ideal entry point for sacral Alar Iliac screws [J]. Asian Spine J 16(6):874\u2013881","journal-title":"Asian Spine J"},{"key":"9011_CR20","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1749-799X-9-22","volume":"9","author":"L Kubaszewski","year":"2014","unstructured":"Kubaszewski L, Nowakowski A, Kaczmarczyk J (2014) Evidence-based support for S1 transpedicular screw entry point modification [J]. J Orthop Surg Res 9:22","journal-title":"J Orthop Surg Res"},{"issue":"11","key":"9011_CR21","doi-asserted-by":"publisher","first-page":"3568","DOI":"10.1007\/s00586-015-4048-1","volume":"25","author":"E Ferrero","year":"2016","unstructured":"Ferrero E, Vira S, Ames CP et al (2016) Analysis of an unexplored group of sagittal deformity patients: low pelvic Tilt despite positive sagittal malalignment [J]. Eur Spine J 25(11):3568\u20133576","journal-title":"Eur Spine J"},{"issue":"5","key":"9011_CR22","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1007\/s00586-006-0221-x","volume":"16","author":"C Schizas","year":"2007","unstructured":"Schizas C, Michel J, Kosmopoulos V et al (2007) Computer tomography assessment of pedicle screw insertion in percutaneous posterior transpedicular stabilization [J]. Eur Spine J 16(5):613\u2013617","journal-title":"Eur Spine J"},{"key":"9011_CR23","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1016\/j.wneu.2018.02.009","volume":"113","author":"E Yilmaz","year":"2018","unstructured":"Yilmaz E, Abdul-Jabbar A, Tawfik T et al (2018) S2 Alar-Iliac screw insertion: technical note with pictorial guide [J]. World Neurosurg 113:e296\u2013e301","journal-title":"World Neurosurg"},{"issue":"5","key":"9011_CR24","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1097\/BRS.0b013e318194128c","volume":"34","author":"TL Chang","year":"2009","unstructured":"Chang TL, Sponseller PD, Kebaish KM et al (2009) Low profile pelvic fixation: anatomic parameters for sacral alar-iliac fixation versus traditional Iliac fixation [J]. Spine (Phila Pa 1976) 34(5):436\u2013440","journal-title":"Spine (Phila Pa 1976)"},{"key":"9011_CR25","doi-asserted-by":"publisher","first-page":"e326","DOI":"10.1016\/j.wneu.2020.08.123","volume":"144","author":"R Tamaki","year":"2020","unstructured":"Tamaki R, Wada K, Okazaki K (2020) Surgical technique and accuracy of S2 Alar-Iliac screw insertion using intraoperative O-Arm navigation: an analysis of 120 screws [J]. World Neurosurg 144:e326\u2013e30","journal-title":"World Neurosurg"},{"issue":"3","key":"9011_CR26","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1007\/s43390-024-01023-6","volume":"13","author":"X Wei","year":"2025","unstructured":"Wei X, Yoshida G, Hasegawa T et al (2025) Male patients with adult spinal deformity: sex differences in demographics, radiography, and complications [J]. Spine Deform 13(3):903\u2013910","journal-title":"Spine Deform"},{"issue":"17","key":"9011_CR27","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1097\/BRS.0000000000002146","volume":"42","author":"R Lafage","year":"2017","unstructured":"Lafage R, Schwab F, Glassman S et al (2017) Age-Adjusted alignment goals have the potential to reduce PJK [J]. Spine (Phila Pa 1976) 42(17):1275\u20131282","journal-title":"Spine (Phila Pa 1976)"},{"issue":"5","key":"9011_CR28","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.jspd.2018.12.007","volume":"7","author":"S Oe","year":"2019","unstructured":"Oe S, Togawa D, Hasegawa T et al (2019) The risk of proximal junctional kyphosis decreases in patients with optimal thoracic kyphosis [J]. Spine Deform 7(5):759\u2013770","journal-title":"Spine Deform"},{"issue":"3","key":"9011_CR29","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1007\/s00586-016-4639-5","volume":"26","author":"X Hu","year":"2017","unstructured":"Hu X, Lieberman IH (2017) Robotic-guided sacro-pelvic fixation using S2 alar-iliac screws: feasibility and accuracy [J]. Eur Spine J 26(3):720\u2013725","journal-title":"Eur Spine J"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-09011-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-025-09011-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-09011-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T16:18:42Z","timestamp":1757953122000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-025-09011-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["9011"],"URL":"https:\/\/doi.org\/10.1007\/s00586-025-09011-8","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,10]]},"assertion":[{"value":"31 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}