S2 alar-iliac screw

The S2 alar-iliac (S2AI) screw is a modification of the traditional iliac fixation technique using the space between the neural foramina of S1 and S2 as an insertion point to fix the sacrum to the ilium.

Traumatic sacral spondyloptosis adds a degree of difficulty to reduction, fixation, and fusion. The technique presented herein achieved sagittal realignment via a distraction maneuver of S1-2 in which rods were attached to bilateral dual S2 alar-iliac screws with reduction screws placed at S1, ultimately pulling L5 and S1 up to the rod for fixation ¹⁾.