Radiology Department, University Hospital, Centre Hospitalier Universitaire de Nice, Route de saint Antoine de Ginestiere, 06200, Nice, France.
Cardiovasc Intervent Radiol. 2009 Nov;32(6):1227-34. doi: 10.1007/s00270-009-9618-3. Epub 2009 Jun 25.
Secondary to the progress in interventional imaging, new therapeutic options have been developed that decrease potential complications because they are minimally invasive and they decrease patient rehabilitation time. As a diagnostic modality, computed axial tomography (CAT) allows precise evaluation of the degree of sacroiliac reduction that must be performed. Moreover, the use of CAT enables easy positioning of screws across the sacroiliac joint, thus avoiding nerve and vascular damage. We report our clinical experience of 20 patients treated by CAT-guided percutaneous fixation for posttraumatic unilateral sacroiliac disruption, including evaluation of our technique, its safety, and patient outcomes and long-term results. All patients in this study had successful outcomes, which were judged according to how much pain they experienced and how quickly they resumed normal activity after the procedure. Twelve of 16 patients were able to return to work by postoperative month 2. One patient had degenerative sacroiliac joint syndrome (5%), which was confirmed 6 months after surgery by CAT scan. None of the patients showed radiologic or clinical evidence of instability of the sacroiliac joint or screw migration. Postoperative follow-up, performed at 1, 2, and 3 years in our rehabilitation department, showed stable results over time. All pain disappeared, without the need for medication, in 19 patients (95%).
随着介入影像学的进步，新的治疗选择得以发展，这些选择的微创性和减少患者康复时间的特点降低了潜在的并发症风险。作为一种诊断方式，计算机轴向断层扫描（CAT）允许对必须进行的骶髂关节复位程度进行精确评估。此外，CAT 的使用可以方便地在骶髂关节上定位螺钉，从而避免神经和血管损伤。我们报告了 20 例采用 CAT 引导经皮固定治疗创伤后单侧骶髂关节脱位的临床经验，包括对我们的技术、安全性以及患者结局和长期结果进行评估。本研究中的所有患者均取得了成功的结果，根据术后患者的疼痛程度和恢复正常活动的速度来判断。16 例患者中有 12 例在术后第 2 个月即可恢复工作。1 例患者出现退行性骶髂关节综合征（5%），术后 6 个月通过 CAT 扫描确诊。所有患者均未出现骶髂关节不稳定或螺钉迁移的影像学或临床证据。在我们的康复科进行的 1、2 和 3 年的术后随访显示，结果随时间稳定。19 例患者（95%）的所有疼痛均消失，无需药物治疗。
