Neurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, Toulon Cedex 9, 83800, France.
Neurosurg Rev. 2024 Jun 21;47(1):282. doi: 10.1007/s10143-024-02515-9.
Unstable traumas of the spinopelvic junction, which include displaced U-shaped sacral fractures (Roy-Camille type 2 and type 3) and Tile C vertical shear pelvic ring disruptions, occur in severe traumas patients following high speed traffic accident or fall from a height. These unstable traumas of the spinopelvic junction jeopardize one's ability to stand and to walk by disrupting the biomechanical arches of the pelvis, and may also cause cauda equina syndrome. Historically, such patients were treated with bed rest and could suffer a life-long burden of orthopedic and neurological disability. Since Schildhauer pioneer work back in 2003, triangular spinopelvic fixation, whether it is performed in a percutaneous fashion or by open reduction and internal fixation, allows to realign bone fragments of the spinopelvic junction and to resume walking within three weeks. Nevertheless, such procedure remains highly technical and it not encountered very often, even for spine surgeons working in high-volume level 1 trauma centers. Hence, this visual technical note aims to provide a few tips to guide less experience surgeons to complete this procedure safely.
不稳定的脊柱骨盆连接部创伤，包括移位的 U 形骶骨骨折（Roy-Camille 2 型和 3 型）和 Tile C 型垂直剪切骨盆环破裂，发生于高速交通事故或高处坠落等严重创伤患者。这些不稳定的脊柱骨盆连接部创伤通过破坏骨盆的生物力学弓，危及站立和行走的能力，还可能导致马尾综合征。历史上，此类患者采用卧床休息治疗，可能终生承受骨科和神经功能残疾的负担。自 Schildhauer 于 2003 年开创性工作以来，三角脊柱骨盆固定术（无论是经皮还是切开复位内固定）都可以使脊柱骨盆连接部的骨碎片重新对线，并在 3 周内恢复行走。然而，即使对于在高容量 1 级创伤中心工作的脊柱外科医生来说，该手术仍然具有很高的技术难度，并不常见。因此，本可视化技术说明旨在提供一些技巧，指导经验较少的外科医生安全完成该手术。
