Weigelt Lizzy, Laux Christoph J, Slankamenac Ksenija, Ngyuen Thi D L, Osterhoff Georg, Werner Clément M L
Division of Trauma Surgery.
Department of Surgery.
Clin Spine Surg. 2019 Apr;32(3):E140-E144. doi: 10.1097/BSD.0000000000000749.
This is a retrospective data analysis.
The aim of this study was to analyze the prevalence of sacral dysmorphism and its correlation to the size of the sacroiliac joint (SIJ) surface based on computed tomography (CT) scans.
Sacroiliac screw fixation is a widely accepted technique for stabilization of posterior pelvic ring injuries. Safe sacral screw placement may be impaired by sacral dysmorphism. The prevalence and impact of sacral dysmorphism on the size of the SIJ surface is unknown.
In total, 269 CT scans were evaluated for the presence of the 5 signs of sacral dysmorphism (mammillary bodies, tongue-in-groove, residual upper sacral disk space, colinearity, and dysmorphic sacral neural foramina). The size of the SIJ surface was calculated by measuring the sacral joint line of the SIJ on each axial CT slice. Logistic regression analyses were conducted to reveal sex-related or age-related differences and correlations between the presence of the dysmorphic signs and the size of the SIJ surface.
Prevalence rates of the dysmorphic signs ranged from 5% (colinearity) to 70% (residual sacral disk space). Only 15% did not show any sign of sacral dysmorphism. The average size of the SIJ surface was 7.36 cm; it was significantly larger in male (8.46 cm) than in female (6.11 cm) patients (P<0.001). The presence of tongue-in-groove morphology was associated with a significantly larger SIJ surface (P<0.001), the presence of a residual upper sacral disk space with a significantly smaller joint surface (P=0.006).
The prevalence of sacral dysmorphism is remarkably high in a normal population and it is questionable if the respective signs should be called dysmorphic after all. The possibility of a smaller joint surface in female patients and patients with a residual upper sacral disk space should be considered in the planning of iliosacral screw placement.
这是一项回顾性数据分析。
本研究旨在基于计算机断层扫描（CT）分析骶骨形态异常的患病率及其与骶髂关节（SIJ）表面大小的相关性。
骶髂螺钉固定是一种广泛接受的用于稳定骨盆后环损伤的技术。骶骨形态异常可能会影响骶骨螺钉的安全置入。骶骨形态异常对SIJ表面大小的患病率和影响尚不清楚。
总共评估了269例CT扫描，以确定是否存在5种骶骨形态异常体征（乳突、榫槽、残留上骶椎间隙、共线性和骶骨神经孔形态异常）。通过测量每个轴向CT切片上SIJ的骶骨关节线来计算SIJ表面的大小。进行逻辑回归分析以揭示性别或年龄相关差异以及形态异常体征的存在与SIJ表面大小之间的相关性。
形态异常体征的患病率从5%（共线性）到70%（残留骶椎间隙）不等。只有15%没有显示出任何骶骨形态异常的迹象。SIJ表面的平均大小为7.36 cm；男性（8.46 cm）明显大于女性（6.11 cm）患者（P<0.001）。榫槽形态的存在与明显更大的SIJ表面相关（P<0.001），残留上骶椎间隙的存在与明显更小的关节表面相关（P=0.006）。
在正常人群中，骶骨形态异常的患病率非常高，这些体征是否应被称为形态异常值得怀疑。在计划髂骶螺钉置入时，应考虑女性患者和有残留上骶椎间隙的患者关节表面较小的可能性。
