Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
Sci Rep. 2017 Aug 11;7(1):7925. doi: 10.1038/s41598-017-08262-w.
The aim of this study was to evaluate the safety and efficacy of percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle clinically. This case series includes 58 consecutive unstable pelvic injury patients, which were treated with iliosacral screws between July 2011 and July 2016. Patients were divided into two groups: normal sacrum (n = 31) and dysmorphic sacrum (n = 27). A single orthopedic surgeon operated on all patients, with percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle. The time needed for screw insertion and the radiation exposure time were recorded. Chi-squared test and Student t-test were used to analyze the differences between the two groups. Sacral dysmorphism was present in 47% of patients. The median time for screw insertion and radiation exposure time in these two groups showed no statistical difference (P > 0.05). No clinical complications or malpositioned screws occurred in any case. Preoperative pelvic CT is necessary to determine the sacral osseous anatomy. In patients with either a normal or dysmorphic sacrum, iliosacral screws can be placed by this method with less radiation exposure and complications than in the conventional method.
本研究旨在评估经 S1 椎弓根轴向投影指导下经皮置入髂骶螺钉的安全性和有效性。该病例系列包括 2011 年 7 月至 2016 年 7 月期间接受髂骶螺钉治疗的 58 例不稳定骨盆损伤患者。患者分为两组：正常骶骨（n=31）和畸形骶骨（n=27）。所有患者均由一名骨科医生进行手术，经 S1 椎弓根轴向投影引导下经皮置入髂骶螺钉。记录螺钉插入所需的时间和辐射暴露时间。采用卡方检验和 Student t 检验分析两组间的差异。47%的患者存在骶骨畸形。两组螺钉插入时间和辐射暴露时间的中位数无统计学差异（P＞0.05）。在任何情况下均未发生临床并发症或螺钉位置不当。术前骨盆 CT 对于确定骶骨骨骼解剖结构是必要的。对于正常或畸形骶骨的患者，通过这种方法可以置入髂骶螺钉，其辐射暴露和并发症少于传统方法。
