Meta-analysis of clinical efficacy of second sacral alar-iliac fixation and iliac screw fixation in adult spinal pelvis fixation

Objective In order to provide a basis for the choice of clinical fixation methods, meta-analysis was used to compare the clinical effects of second sacral alar-iliac(S2AI) fixation versus iliac screw(IS) fixation in adult fixation. Methods An extensive search of literature was performed in CNKI Database, Wanfang Database, PubMed Database, Cochrane Database and OVID Database, 脊柱骨盆 髂骨(螺)钉 骶髂(螺)钉 and spinal pelvis iliac screw(s) sacroiliac screw(s) as key words. The Chinese and English literatures on the comparative study of the clinical effects of IS fixation techniques and S2AI fixation techniques for posterior pelvic fixation had been collected until December 2017. The Jadad quality scoring method was used to evaluate the quality of the included literature, and the relevant data of the article was extracted. The Meta-analysis was performed by Revman 5.3 statistical software. Results A total of 310 patients were enrolled in 5 studies, including 3 high-quality literature and 2 medium-quality literature. Meta analysis shows that for adult spine pelvic fixation, the incidence of operation time(SMD=0.40, 95%CI 0.08-0.73, P=0.02), postoperative infection complications(RR=6.15, 95%CI 2.83-13.35, P<0.01)and internal fixation failure(RR=4.09, 95%CI 1.72-9.73, P=0.001)of S2AI fixed technology were lower, the difference was statistically significant, however pooled estimates showed no significant difference in hospitalization days(WMD=1.07, 95%CI -0.60-2.75, P=0.21) , intraoperative blood loss(SMD=0.29, 95%CI -0.03-0.62, P=0.08) and postoperative visual analogue scale(WMD=0.13, 95%CI -0.62-0.88, P=0.73). Conclusions S2AI fixation technology and IS fixation technology can achieve satisfactory clinical results in adult pelvic fixation, However, the S2AI fixation technique has a greater advantage in terms of operative time, postoperative infection rate, and incidence rate of internal fixation failure. Key words: Internal fixators; S2 alar-iliac screw; Iliac screw; Spine pelvic fixation; Meta-analysis