Evidence map›Paper›PMID 41922625›Full record

ArticleActa neurochirurgica2026

Modified iliac screw technique for pelvic fixation: a scoping review of technical characteristics and early clinical outcomes.

Hanyu Qiu, Dhruvish Patel, Moriah Thompson, Piper Tingleaf, Kishore Balasubramanian, Peter G Passias, Luis M Tumialan, Praveen V Mummaneni, Nitin Agrawal, Ali K Ozturk and 7 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Hanyu Qiu *Department of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Dhruvish Patel *Department of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Moriah ThompsonDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Piper TingleafDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Kishore BalasubramanianDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Peter G PassiasDepartment of Neurosurgery and Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Luis M TumialanDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Praveen V MummaneniDepartment of Neurological Surgery, University of California San Francisco Medical Center, San Francisco, CA, USA.
Nitin AgrawalDepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ali K OzturkDepartment of Neurosurgery, University of Pennsylvania Hospital, Philadelphia, PA, USA.
Hakeem J ShakirDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
John F BurkeDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Chao LiDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Zachary A SmithDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Andrew JeaDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA.
Angela E DownesDepartment of Neurosurgery, Texas Health Physicians Group, Arlington, TX, USA.
M Burhan JanjuaDepartment of Neurosurgery, University of Oklahoma College of Medicine, 1000 N. Lincoln Blvd., Ste. 4000, Oklahoma City, OK, 73104, USA. Muhammad-Janjua-1@ou.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIliac screws remain essential in cases requiring spinopelvic fixation, providing distal anchorage and construct stability across many surgical indications. However, traditional posterior-superior-iliac-spine (PSIS) entry screws are associated with hardware prominence, postoperative pain, and the need for side-to-side connectors to link with primary rods. The S2 alar-iliac (S2AI) technique addresses these drawbacks but some series have reported higher mechanical failure rates due to acute screw angulation. Furthermore, the S2AI trajectory violates the sacroiliac (SI) joint, potentially limiting use in cases with compromised sacral anatomy. The modified iliac screw (MIS) technique was developed to overcome these issues by shifting the entry point medial to the PSIS, maintaining iliac purchase while avoiding SI joint involvement. This scoping review synthesizes early clinical usage and implant performance of this emerging technique.

methodsA scoping review following PRISMA guidelines was conducted across PubMed, MEDLINE, and Embase through Sep 28, 2025. Eligible studies included reports describing patient outcomes following fixation using modified iliac screws.

resultsA total of 162 patients across 6 studies were included. The cohort had a mean age of 64.5 years (range; 18-78). The most common indication was deformity (62.3%; n = 101), followed by fixation following tumor resection (17.9%; n = 29) and degenerative disease (9.3%; n = 15). The mean number of fixed vertebrae was 8.01 (range; 3-18). Mean follow-up time was 19.19 months (range; 3-74). Implant complications were reported in 36 cases (22.2%), commonly screw perforation (n = 22), screw fracture (n = 5), and screw loosening (n = 4). Complications led to implant failure for 7 patient cases (4.3%).

conclusionEarly experiences with MIS fixation demonstrate promising clinical utility with acceptable rates of hardware-related complications and morbidity. However, existing evidence remains limited to small, heterogeneous series without standardized outcome reporting. Robust prospective investigations with larger cohorts and standardized long-term follow-up are needed to comprehensively characterize the safety, durability, and comparative performance of the MIS technique.

Indexed as

Bone ScrewsIliumSpinal FusionHumansSacroiliac JointSacrumTreatment OutcomeLumbosacral fusionModified iliac screwSpinal deformitySpinopelvic fixation

Identifiers

PMID41922625
PMCPMC13046568

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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.