Screw Placement and Osteoplasty Under Computed Tomographic–Fluoroscopic Guidance in a Case of Advanced Metastatic Destruction of the Iliosacral Joint
October 5, 2009 by admin
Screw Placement and Osteoplasty Under Computed Tomographic–Fluoroscopic Guidance in a Case of Advanced Metastatic Destruction of the Iliosacral Joint
We present a case of combined surgical screw placement and osteoplasty guided by computed tomography–fluoroscopy (CTF) in a 68-year-old man with unilateral osteolytic destruction and a pathological fracture of the iliosacral joint due to a metastasis from renal cell carcinoma. The patient experienced intractable lower back pain that was refractory to analgesia. After transarterial particle and coil embolization of the tumor-feeding vessels in the angiography unit, the procedure was performed under general anesthesia by an interdisciplinary team of interventional radiologists and trauma surgeons. Under intermittent single-shot CTF, two K wires were inserted into the left iliosacral joint from a lateral transiliac approach at the S1 level followed by two self-tapping surgical screws….
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