From the Department of Orthopedic Surgery, Naval Medical Center, San Diego, CA (Dr. Quacinella and Dr. Morrissey), and the Department of Orthopedic Surgery, Denver Health Medical Center, CO (Dr. Parry and Dr. Mauffrey).
J Am Acad Orthop Surg. 2020 Dec 15;28(24):e1086-e1096. doi: 10.5435/JAAOS-D-19-00863.
Spinopelvic dissociation is a rare injury associated with 2% to 3% of transverse sacral fractures and 3% of sacral fractures associated with pelvic ring injuries. When spinopelvic dissociation is expediently identified and treated appropriately, patient outcomes can be maximized, highlighting the importance of early diagnosis and treatment. Because of its rarity and complexity, there remains a paucity of high-level evidence-based guidance on treating this complex issue. No consensus exists on fixation techniques or reduction maneuvers to achieve stability, allowing for early functional rehabilitation. The purpose of this article is to review the current body of literature to better understand this injury pattern to help establish a treatment algorithm that appropriately guides the treating surgeons in the surgical planning and perioperative care of these patients.
脊柱骨盆分离是一种罕见的损伤，与 2%至 3%的横突骶骨骨折和 3%的与骨盆环损伤相关的骶骨骨折有关。当脊柱骨盆分离被及时识别并进行适当治疗时，可以最大限度地提高患者的治疗效果，突出了早期诊断和治疗的重要性。由于其罕见性和复杂性，目前仍然缺乏针对这一复杂问题的高水平循证治疗指南。在固定技术或复位手法以实现稳定性方面，尚未达成共识，这有利于早期的功能康复。本文的目的是回顾目前的文献，以更好地了解这种损伤模式，帮助建立一种治疗算法，为治疗这些患者的外科医生在手术计划和围手术期护理方面提供适当的指导。
