Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21224–2780, USA.
Spine (Phila Pa 1976). 2010 Dec 1;35(25):2245-51. doi: 10.1097/BRS.0b013e3181f5cfae.
Literature-based topic review.
To review the indications and techniques for different sacropelvic fixation methods and to outline important associated complications.
Despite all the advances and new developments in spinal instrumentation techniques, fixation at the lumbosacral junction continues to be one of the important challenges to spine surgeons. The poor bone quality of the sacrum, the complex regional anatomy, and the tremendous biomechanical forces at the lumbosacral junction contribute to the high rates of instrumentation-related problems. Although many techniques for sacropelvic fixation have been attempted, only a few are still widely used because of the high rate of complications associated with some of those techniques.
Review of literature and expert opinion.
There are many indications for sacropelvic fixation. Long fusions to the sacrum are the most common reasons for extending the instrumentation to the pelvis. Spinal surgeons performing complex spinal reconstruction should be familiar with the currently available techniques, including their potential risks and complications. Surgical treatment decisions should be based on an individual patient's anatomy and abnormalities, and on the surgeon's experience.
基于文献的主题综述。
回顾不同骶骨骨盆固定方法的适应证和技术,并概述相关的重要并发症。
尽管脊柱器械技术取得了所有进步和新发展,但腰骶连接部的固定仍然是脊柱外科医生面临的重要挑战之一。骶骨的骨质差、区域解剖结构复杂以及腰骶连接处的巨大生物力学力导致器械相关问题的发生率很高。尽管已经尝试了许多骶骨骨盆固定技术,但由于某些技术相关并发症的发生率高,只有少数技术仍被广泛应用。
文献回顾和专家意见。
骶骨骨盆固定有许多适应证。向骶骨延长融合是将器械扩展到骨盆的最常见原因。进行复杂脊柱重建的脊柱外科医生应熟悉目前可用的技术,包括其潜在风险和并发症。手术治疗决策应基于患者个体的解剖结构和异常情况,以及外科医生的经验。