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screws. Failure-free survival rate was 92.5% at 1 year, 85.9% at 2 years, and 78.2% at 3 years. Failure was more common in patients with iliac bolts than those with S2AI screws (9 vs. 2; p=0.026). Four patients with iliac bolts developed nonunion at L5-S1. Placement of iliac bolts (OR 12.8, 95% CI [1.81, 191.42]), number of levels fused (1.6, [1.15, 2.40]), and age (0.9, [0.78, 0.97]) were significantly associated with failure. Reason for pelvic fixation, pelvic screw length, number of previous fusion operations, smoking, and use of BMP were not associated with