König M A, Sundaram R O, Saville P, Jehan S, Boszczyk Bronek M
The Centre for Spinal Studies and Surgery, Queens Medical Centre Campus, Nottingham University Hospital NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
Eur Spine J. 2016 Jun;25(6):1800-5. doi: 10.1007/s00586-015-4327-x. Epub 2015 Nov 17.
To determine the presence of a consistent osseous corridor through S1 and S2 and fluoroscopic landmarks thereof, which could be used for safe trans ilio-sacroiliac screw fixation of posterior pelvic ring disorders.
Computed tomography (CT) based anatomical investigation utilising multiplanar image and trajectory reconstruction (Agfa-IMPAX Version 5.2 software). Determination of the presence and dimension of a continuous osseous corridor in the coronal plane of the sacrum at the S1 and S2 vertebral levels.
Determination of: (a) the presence of an osseous corridor in the coronal plane through S1 and S2 in males and females; (b) the dimension of the corridor with regard to diameter and length; (c) the fluoroscopic landmarks of the corridor.
The mean cross-sectional area for S1 corridors in males and females was 2.13 and 1.47 cm(2) , respectively. The mean cross-sectional area for the S2 corridor in males and females was 1.46 and 1.13 cm(2), respectively. The limiting anatomical factor is the sagittal diameter of the sacral ala at the junction to the vertebral body. The centre of the S1 and S2 corridor is located in close proximity to the centre of the S1 and S2 vertebrae on the lateral fluoroscopic view as determined by the adjacent endplates and anterior and posterior vertebral cortices.
Two-thirds of males and females have a complete osseous corridor to pass a trans-sacroiliac S1 screw of 8 mm diameter. The S2 corridor was present in all males but only in 87 % of females. Preoperative review of the axial CT slices at the midpoint of the S1 or S2 vertebral body allows the presence of a trans-sacroiliac osseous corridor to be determined by assessing the passage at the narrowest point of the corridor at the junction of the sacral ala to the vertebral body.
确定一条穿过S1和S2的连续骨通道及其透视标志的存在情况，该通道可用于骨盆后环疾病的安全经髂-骶髂螺钉固定。
基于计算机断层扫描（CT）的解剖学研究，利用多平面图像和轨迹重建（爱克发-影像大师5.2版软件）。确定骶骨在S1和S2椎体水平冠状面上连续骨通道的存在情况和尺寸。
确定：（a）男性和女性在冠状面穿过S1和S2的骨通道的存在情况；（b）通道在直径和长度方面的尺寸；（c）通道的透视标志。
男性和女性S1通道的平均横截面积分别为2.13平方厘米和1.47平方厘米。男性和女性S2通道的平均横截面积分别为1.46平方厘米和1.13平方厘米。限制解剖因素是骶骨翼与椎体交界处的矢状径。根据相邻终板以及椎体前后皮质，在侧位透视视图上，S1和S2通道的中心紧邻S1和S2椎体的中心。
三分之二的男性和女性有完整的骨通道来通过直径8毫米的经骶髂S1螺钉。所有男性均存在S2通道，而女性中只有87%存在。术前在S1或S2椎体中点对轴向CT切片进行评估，通过在骶骨翼与椎体交界处通道最窄点评估其通过情况，可确定经骶髂骨通道的存在情况。
