Minimum 2-Year Analysis of S2-Alar-Iliac Screw Fixation for Adult Spinal Deformity

Alex S. Ha, Daniel Y. Hong, Andrew J. Luzzi, Josephine R. Coury, Meghan Cerpa, Zeeshan Sardar, Lawrence G. Lenke

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Study Design: Retrospective cohort. Objective: Determine the rate and risk factors for S2AI screw-related pain after adult spinal deformity surgery with a minimum 2-year follow-up. Methods: A consecutive 83 spinal deformity patients undergoing surgical treatment between August 2015 and December 2017 with minimum 2-year follow-up for S2AI screw complication and screw-related pain were included. Linear regression was performed on various risk factors and postoperative S2AI screw-related pain. Subset analysis of 53 patients was performed on preoperative and postoperative SRS and ODI scores, operative data, and radiographic data. Results: The overall proportion of S2AI screw-related pain was 9.6%. An S2AI screw complication was identified radiographically in 10.8% of patients; among these, 22.2% experienced S2AI screw-related pain. 3.4% of all patients underwent S2A1 screw removal. The SRS, ODI, sagittal vertical axis (SVA), and coronal alignment scores/measurements improved following treatment in all patients. However, the mean difference for the pre and postoperative SRS function score (1.2 ± 0.5 vs 0.9 ± 0.8) and SVA (4.0 ± 4.9 cm vs 2.1 ± 4.8 cm) were higher for the pain group. Conclusions: A minimum 2-year analysis of S2AI screw fixation in adult spinal deformity patients showed that 9.6% of patients experienced S2AI screw-related pain and 3.4% of patients had S2A1 screws removed. The size and the number of S2AI screws did not predict postoperative pain, nor were radiographic findings correlated with clinical outcomes. The patient outcome scores, coronal alignment, and SVA improved for all patients, but within the pain group there was an overall larger change in the SVA and SRS function score.

Original languageEnglish (US)
Pages (from-to)1640-1646
Number of pages7
JournalGlobal Spine Journal
Issue number8
StatePublished - Oct 2022
Externally publishedYes


  • S2AI screws
  • adult spine deformity
  • complications
  • pelvic fixation
  • spine surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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