THE IMPORTANCE OF SACRUM MORPHOLOGY IN TRANSSACRAL AND ILIOSACRAL SCREW FIXATION

Abstract

Objective: In this study, it was aimed to put forward the effects of the morphological characteristics of the sacrum on the choice of iliosacral or transsacral screwing.

Material and Methods: The study was carried out on 224 patients who underwent computerized tomographic imaging of the pelvis between May 2016 and May 2019. By reviewing the images of the patients, parameters such as sacrum types, applicability for transsacral screwing, the narrowest diameter of the bone corridor in the coronal plane where the screw was placed properly, and the anteversion angle of the screw were evaluated. Moreover, the distribution of these data according to age and gender was compared between the groups.

Results: Of the patients' sacrums; 72 (32.1%) were the ascending type, 28 (12.5%) were the descending type, 106 (47.3%) were the horizontal type, and 18 (8%) were the dysmorphic type. While transsacral screwing could be performed in 136 (60%) of the sacrums, it was not possible in 88 (40%). The width of the narrowest part where the iliosacral screw would pass was 19.52 (52 (min-max:11.8-47)) mm on average in all patient groups. There was no difference only between the horizontal and the descending types in terms of the narrowest diameter through which the iliosacral screw would pass. The anteversion angle of the iliosacral screw was 25.4 (min-max:5-52.5) degrees on average in all patients. The anteversion angle of the iliosacral screw varied between all sacrum types.

Conclusion: Differences in the sacrum morphology in patients who will undergo iliosacral or transsacral screwing affect the choice of surgery to be applied. For this reason, preoperative surgical planning is essential according to the sacrum morphology.

Keywords

• Transsacral screwing
• iliosacral screwing
• screw anteversion angle
• sacral morphology
• surgery decision

Project Number

YOK

Transsakral ve İliosakral Vida Tespitinde Sakrum Morfolojisinin Önemi

Abstract

Amaç: Bu çalışmada; sakrumun morfolojik özelliklerinin iliosakral veya transsakral vidalama seçimi üzerine olan etkilerinin ortaya konulması amaçlanmıştır.

Gereç ve Yöntemler: Çalışma, Mayıs 2016-Mayıs 2019 yılları arasında pelvis bilgisayarlı tomografi görüntülemesi yapılan 224 hasta üzerinde yapılmıştır. Hastaların görüntülerinden yararlanılarak sakrum tipleri, transsakral vidalama için uygulanabilirlik, uygun yerleşimli vidanın yerleştiği kemik koridorun koronal plandaki en dar çapı ve vidanın anteversiyon açısı gibi parametreler değerlendirilmiştir. Ayrıca elde edilen bu verilerin yaşa ve cinsiyete göre dağılımları da gruplar arasında kıyaslanmıştır.

Bulgular: Hastaların sakrumlarının 72’si (%32,1) asendan tip; 28’i (%12,5) desendan tip; 106’sı (%47,3) horizontal tip; 18’i (%8) dismorfik tipti. Sakrumların 136’sına (%60) transsakral vidalama yapılabilirken, 88’ine (%40) transsakral vidalama yapılamıyordu. İliosakral vidanın geçeceği en dar yerin genişliği bütün hasta grubunda ortalama 19,52 (min-max:11.8-47) mm idi. İliosakral vidanın geçeceği en dar çap açısından sadece horizontal ve desenden tip arasında farklılık yoktu. İliosakral vidanın anteversiyon açısı bütün hastalarda ortalama 25,4 (min-max: 5-52.5) dereceydi. İliosakral vidanın anteversiyon açısı bütün pelvis tipleri arasında farklılık göstermekteydi.

Sonuç: İliosakral veya transsakral vidalama yapılacak hastalarda sakrum morfolojisinde görülecek farklılıklar uygulanacak cerrahi seçimi etkiler. Bundan dolayı sakrum morfolojisine göre preoperatif cerrahi planlama elzemdir.

Keywords

• Transsakral vidalama
• iliosakral vidalama
• vida anteversiyon açısı
• sakrum morfolojisi
• cerrahi seçim

Supporting Institution

YOK

Project Number

YOK

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