Kweh Barry Ting Sheen, Vaccaro Alexander R, Schroeder Gregory, Canseco Jose A, Reinhold Maximilian, Aly Mohamed, Bigdon Sebastian, El-Skarkawi Mohammad, Bransford Richard J, Joaquim Andrei Fernandes, Chhabra Harvinder Singh, Vialle Emiliano, Kanna Rishi M, Dandurand Charlotte, Öner Cumhur, Tee Jin Wee
National Trauma Research Institute, Melbourne, VIC, Australia.
Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia.
Global Spine J. 2025 Sep 13:21925682251379358. doi: 10.1177/21925682251379358.
Study DesignSystematic Review.ObjectivesTo detail every historical classification system of the sacrum and pelvis and their resultant integration into the encompassing AO Spine Sacral Injury Classification System.MethodsA systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.Results49 studies were included in the systematic review. Historical systems fail to provide clinicians with a rational method of determining whether operative or non-operative management is appropriate. Fracture morphologies are presented in a non-hierarchical manner without considering crucial treatment changing factors such as degree of neurological injury or associated anterior pelvic injury. The AO Spine Sacral Injury Classification System introduces sacrum and pelvic fractures in a clinically meaningful manner ranging from the usually stable type A bony injures of the lower sacrococcygeal region, to the type B posterior pelvic injuries potentially involving the sacral foramina, and finally the type C unstable spino-pelvic injuries.ConclusionsThe sacrum and pelvis are biomechanically related structures and should be evaluated as a unified entity rather than separately as has been historically suggested. The AO Spine Sacral Injury Classification System achieves this by considering the integrity of the spino-pelvic bony as well as supporting ligamentous structures, whilst simultaneously providing a graded framework to guide whether surgical or non-surgical management is most appropriate.
研究设计
系统评价。
目的
详细阐述骶骨和骨盆的每一种历史分类系统，以及它们最终如何整合到涵盖性的AO脊柱骶骨损伤分类系统中。
方法
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，对MEDLINE、EMBASE和Cochrane数据库进行了系统评价。
结果
49项研究纳入了该系统评价。历史分类系统未能为临床医生提供一种合理的方法来确定手术或非手术治疗是否合适。骨折形态的呈现方式没有层次，未考虑关键的治疗改变因素，如神经损伤程度或相关的骨盆前部损伤。AO脊柱骶骨损伤分类系统以一种具有临床意义的方式引入骶骨和骨盆骨折，范围从通常稳定的下骶尾区域A型骨损伤，到可能累及骶孔的B型骨盆后部损伤，最后是C型不稳定的脊柱骨盆损伤。
结论
骶骨和骨盆是生物力学相关的结构，应作为一个统一的整体进行评估，而不是像历史上所建议的那样分别评估。AO脊柱骶骨损伤分类系统通过考虑脊柱骨盆骨以及支持韧带结构的完整性来实现这一点，同时提供一个分级框架来指导最合适的手术或非手术治疗。
