Does Laterality Matter? The Effect of Unilateral v. Bilateral Sacroiliac Screw Fixation on Personal Hygiene. Issue 4 (May 2023)

• Record Type: Journal Article
• Authors: Deckey, David G.; Gulbrandsen, Matthew T.; Hinckley, Nathaniel B.; Lara, Nina; Mayfield, Cory K.; Makovicka, Justin L.; Adeniyi, Biodun; Chang, Michael S.
• Is Part Of: Global spine journal. Volume 13:Issue 4(2023)
• Page Start: 1036
• Page End: 1041
• Publication Date: 2023-05
• Subjects: spine deformity -- sacroiliac fixation -- personal hygiene -- hand dominance -- unilateral sacroiliac fixation; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/21925682211015675
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Retrospective comparative analysis of prospective cohort. Objective: To determine whether sacroiliac (SI) screw fixation ipsilateral to hand dominance compared to bilateral fixation impacts personal hygiene (wiping) after toileting. Methods: Inclusion criteria were adult spinal deformity (ASD) patients with long arthrodesis (≥T12-pelvis) who had undergone primary unilateral or bilateral SI fixation with a minimum of 2-years-follow-up. Results: 117 consecutive patients were included and separated into 2 groups: bilateral SI fixation (BL, n = 61) and unilateral SI fixation (UNI, n = 56), with no difference in age. Of UNI patients, 10.7% (6) performed personal hygiene with a different hand after surgery, compared to 6.6% (4) of patients who received BL fixation ( P = 0.422). All UNI patients who switched hands were right-hand dominant, and 5/6 received right-sided fixation. There was no statistical difference found between number of levels fused (<8, 9-11, or >11 levels) and changes in personal hygiene habits. Over a third of patients from both groups had difficulty performing personal hygiene after fusion (UNI = 39.3% BL = 36.1%, P = 0.719). Conclusion: SI screws increase the difficulty of performing personal hygiene; yet, the side of unilateral screws does not significantly change personal hygiene habits when compared to bilateral screw placement. Moreover, the length of the construct does not have a significant impact on ability to perform personal hygiene, cause changes in habits, or require the assistance of another individual. However, among our sample of individuals, bilateral fixation did result in a higher rate of revision instrumentation.