Metastatic renal cell carcinoma of the lumbar spine with long posterior instrumented fusion and repetitive dislodgement of the set screws of the S2 alar-iliac screw

Shinsuke Yoshida; Shunpei Iida; Rei Akagawa; Soichi Oya; Kazuo Saita; Satoshi Ogihara

doi:10.25259/SNI_859_2023

Metastatic renal cell carcinoma of the lumbar spine with long posterior instrumented fusion and repetitive dislodgement of the set screws of the S2 alar-iliac screw

Surg Neurol Int. 2023 Dec 22:14:439. doi: 10.25259/SNI_859_2023. eCollection 2023.

Authors

Shinsuke Yoshida¹, Shunpei Iida², Rei Akagawa², Soichi Oya¹, Kazuo Saita², Satoshi Ogihara²

Affiliations

¹ Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
² Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.

Abstract

Background: S2 alar-iliac screws (S2AIS) are widely used to anchor the pelvis to a lumbar fusion. Here, we report a patient who experienced repetitive dislodgement of the set screws of the S2AIS following a posterior instrumented fusion.

Case description: A 68-year-old male presented with an L3 metastasis and L2-L3 subluxation attributed to renal cell cancer. Following an L2-L5 posterior decompression and T9-pelvic fusion utilizing bilateral S2AIS fixation, the set screws of the S2AIS repeatedly dislodged, requiring two additional operations. The final surgery required multiple anchors to the ilium and provided adequate fixation until the patient's expiration.

Conclusion: The set screw fixing force was weaker than the fixing force of the S2AIS; multiple iliac anchors effectively salvaged this condition.

Keywords: Dislodgement; Multiple anchors; S2 alar-iliac screw; Set screw.

Publication types

Case Reports