Novel endoscopic sacroiliac screw removal technique: reduction of intraoperative radiation exposure.

ABSTRACT

OBJECTIVE: We report in the following on our technique of endoscopic sacroiliacal screw removal as a new extra-articular endoscopic method in soft tissue surgery, aimed at the reduction of radiation exposure for both the patient and the surgical teams. Patients who underwent endoscopic implant removal from the dorsal pelvic ring (Group A) were retrospectively compared with a control group, in which the screws were removed via the conventional approach (Group B). The parameters of interest were the extent of x-ray exposure in seconds and surgical duration in minutes as well as approach related peri- and postoperative complications. RESULTS: 34 screws were removed endoscopically from 28 patients in group A and 35 screws from 29 patients in group B. The mean skin-to-skin time in group A was 36.1 (15-111) min and 32.7 (12-114) min in group B. The difference was not statistically significant (p > 0.05). The average radiation time in group A was 5.7 ± 3.2 s (range, 0-101 s), while in group B the radiation time was significantly longer (52.6 ± 23 s (range, 0-239 s); p = 0.005). CONCLUSIONS: Endoscopic screw removal from the posterior pelvic ring reduces the intraoperative radiation time whereas the skin-to-skin times do not differ from the conventional procedure. LEVEL OF EVIDENCE Case-control study, Level III.