{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T21:37:39Z","timestamp":1780349859595,"version":"3.54.1"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Pelvic fixation is a crucial adjunct to many lumbar fusions to avoid L5\u2013S1 pseudarthrosis. It is useful for treatment of kyphoscoliosis, high-grade spondylolisthesis, L5\u2013S1 pseudarthrosis, sacral tumors, lumbosacral dislocations, and osteomyelitis. The most popular method, iliac fixation, has drawbacks including hardware prominence, extensive muscle dissection, and the need for connection devices. S-2 alar iliac fixation provides a useful primary or salvage alternative. The authors describe their techniques for using stereotactic navigation for screw placement.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The O-arm Surgical Imaging System allowed for CT-quality multiplanar reconstructions of the pelvis, and registration to a StealthStation Treon provided intraoperative guidance. The authors describe their technique for performing computer-assisted S-2 alar iliac fixation for various indications in 18 patients during an 18-month period.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All patients underwent successful bilateral placement of screws 80\u2013100 mm in length. All placements were confirmed with a second multiplanar reconstruction. One screw was moved because of apparent anterior breach of the ilium. There were no immediate neurological or vascular complications due to screw placement. The screw length required additional instruments including a longer pedicle finder and tap.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Stereotactic guidance to navigate the placement of distal pelvic fixation with bilateral S-2 alar iliac fixation can be safely performed in patients with a variety of pathological conditions. Crossing the sacroiliac joint, choosing trajectory, and ensuring adequate screw length can all be enhanced with 3D image guidance. Long-term outcome studies are underway, specifically evaluating the sacroiliac joint.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.2.spine12813","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T14:43:00Z","timestamp":1363358580000},"page":"490-495","source":"Crossref","is-referenced-by-count":58,"title":["Stereotactic navigation with the O-arm for placement of S-2 alar iliac screws in pelvic lumbar fixation"],"prefix":"10.3171","volume":"18","author":[{"given":"Wilson Z.","family":"Ray","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meic H.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of 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