SynthesisSpine deformity2024
S2 alar-iliac screws are superior to traditional iliac screws for spinopelvic fixation in adult spinal deformity: a systematic review and meta-analysis.
Synthesis in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- S2AI and iliac screw prominence and removal for symptomatic prominence: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Current concepts review: Low-vs high-tone neuromuscular spinal deformities: An evolving distinction with clinical implications.Journal of children's orthopaedics · 2026Article
- Incidence and outcomes of spinopelvic fixation loosening following adult spinal deformity surgery.Spine deformity · 2026Article
- S2AI revision surgery - biomechanical evaluation of increased screw diameters.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Removal of spinopelvic S2 alar-iliac osseointegrative screws: a case report and surgical technique guide.Journal of spine surgery (Hong Kong) · 2026Article
- Anterior inferior iliac spine as an anatomical reference for S2-alar-iliac screw placement: a three-dimensional computed tomography-based study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Sacral Insufficiency Fracture Following L4-S1 Circumferential Fusion in Corticosteroid-associated Bone Fragility: A Case Report and Biomechanical Considerations.Journal of orthopaedic case reports · 2026Article
- Critical Assessment of Evidence Quality of Meta-Analyses Comparing Sacral 2 Alar-Iliac Fixation with Iliac Screws for Adult Spinal Deformity: An Umbrella Review with Emphasis on Methodological Limitations.Journal of clinical medicine · 2026Review
- Impact of sex on S2-alar-iliac pelvic screw position and lumbosacral rod alignment in adult spine deformity.Spine deformity · 2026Article
- Sacral Alar-Iliac (SAI) screw diameter is not associated with pelvic fixation failure for neuromuscular scoliosis patients.Spine deformity · 2025Article
- S2AI vs. iliac screws in spinopelvic fixation for adult spinal deformity: a propensity score-matched analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- A Misplaced S2 Alar-Iliac Screw Causing L5 Spinal Nerve Injury: A Report of a Rare Case.Cureus · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSpinopelvic fixation (SPF) using traditional iliac screws has provided biomechanical advantages compared to previous constructs, but common complications include screw prominence and wound complications. The newer S2 alar-iliac (S2AI) screw may provide a lower profile option with lower rates of complications and revisions for adult spinal deformity (ASD). The purpose of this study was to compare rates of complications and revision following SPF between S2AI and traditional iliac screws in patients with ASD.
methodsA PRISMA-compliant systematic literature review was conducted using Cochrane, Embase, and PubMed. Included studies reported primary data on adult patients undergoing S2AI screw fixation or traditional IS fixation for ASD. Primary outcomes of interest were rates of revision and complications, which included screw failure (fracture and loosening), symptomatic screw prominence, wound complications (dehiscence and infection), and L5-S1 pseudarthrosis.
resultsFifteen retrospective studies with a total of 1502 patients (iliac screws: 889 [59.2%]; S2AI screws: 613 [40.8%]) were included. Pooled analysis indicated that iliac screws had significantly higher odds of revision (17.1% vs 9.1%, OR = 2.45 [1.25-4.77]), symptomatic screw prominence (9.9% vs 2.2%, OR = 6.26 [2.75-14.27]), and wound complications (20.1% vs 4.4%, OR = 5.94 [1.55-22.79]). S2AI screws also led to a larger preoperative to postoperative decrease in pain (SMD = - 0.26, 95% CI = -0.50, - 0.011).
conclusionThe findings from this review demonstrate higher rates of revision, symptomatic screw prominence, and wound complications with traditional iliac screws. Current data supports the use of S2AI screws specifically for ASD. PROSPERO ID: CRD42022336515. LEVEL OF EVIDENCE: III.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.