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February 22, 2026OTA International The Open Access Journal of Orthopaedic Trauma1 citationsOpen Access

The crest-pillar-column method for percutaneous fixation of the posterior column using a curved intramedullary device: surgical technique

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GDGrayson DomingueUniversity of Oklahoma Health Sciences CenterCDChristian DeMaioUniversity of Oklahoma Health Sciences CenterJYJohn M. YinglingUniversity of Oklahoma Health Sciences Center

Key Points

  • The aim is to describe a new method for the fixation of posterior column fractures using a curved intramedullary device.
  • Describes the Crest-Pillar-Column technique for posterior column fixation
  • Utilizes a curved intramedullary implant
  • Accesses the posterior column through the iliac tubercle via the gluteal pillar
  • Focuses on minimally invasive surgical approach
  • Provides an innovative method that reduces the need for traditional open surgery
  • Facilitates easier access to challenging anatomical locations
  • Suggests improved patient positioning and sterility during surgery

Abstract

Abstract Treatment of posterior column fractures can be treated with open reduction internal fixation via plate osteosynthesis or with screw fixation. Due to common fracture planes and fixation trajectories, traditional anterograde posterior column screw fixation requires an open approach to access the starting point on the inner table. Retrograde posterior column implantation requires a start point in areas that are difficult to drape and access with familiar patient positioning and confident sterility. The advent of curved intramedullary implants allows implantation in nonlinear osseous fixation pathways. This technical paper describes a novel minimally invasive approach to placing a curved intramedullary implant within the posterior column from the readily identifiable iliac tubercle via the gluteal pillar (“Crest-Pillar-Column” technique).

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Cite This Study

Domingue et al. (2026) studied this question.

synapsesocial.com/papers/699a9d8e482488d673cd3860https://doi.org/10.1097/oi9.0000000000000471
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