Investigation of the Effect of Screw Fixation of Sacroiliac Luxation on Pelvic Canal Width Ratio in Cats

Öz

The aim of this study was to evaluate the pre- and postoperative effects of screw stabilization on the inter-ilium distance, pelvic canal width, and hemipelvic canal ratios in cats that developed sacroiliac luxation as a result of trauma. The study included 18 cats of different breeds, sexes, ages, and weights that were diagnosed with sacroiliac luxation due to trauma and underwent surgical intervention at the Selcuk University Small Animal Hospital between 2023 and 2024. Clinical, hematological, and radiological examinations were performed. Following medical treatment and rehabilitation of the patients requiring stabilization before surgery, screw fixation was applied between the ilium and sacrum to stabilize the sacroiliac luxation. Among the 18 cases, 16.6% had bilateral sacroiliac luxation, 16.6% had sacroiliac luxation with an ilium fracture, 16.6% had sacroiliac luxation with an ischium fracture, 11.1% had sacroiliac luxation with a pubis fracture, 11.1% had sacroiliac luxation with both pubis and ischium fractures, 5.6% had sacroiliac luxation with an acetabulum fracture, 5.6% had sacroiliac luxation with both acetabulum and ilium fractures, 5.6% had sacroiliac luxation with both ilium and ischium fractures, 5.6% had sacroiliac luxation with pubis and ilium fractures accompanied by femoral head luxation, and 5.6% had sacroiliac luxation with pubis, ilium, ischium, and symphysis pelvis fractures. In 84% of the 18 cases diagnosed with sacroiliac luxation and treated surgically, the postoperative pelvic canal width ratio (PCWR) was found to be ≥1.1. No statistically significant difference was observed between the pre- and postoperative inter-ilium distance and pelvic canal ratios. However, a statistically significant difference was found in the hemipelvic canal ratio between the pre- and postoperative measurements (p<0.05). In this study, the comparison of pre- and postoperative results showed that the inter-ilium distance, pelvic canal, and hemipelvic canal ratios approached a normal anatomical structure postoperatively. In the choice of surgical technique, the dorsal approach to expose the ilium body facilitated the application.

Anahtar Kelimeler

• Hemipelvic canal ratios
• ilium distance
• pelvic canal rations
• screw fixation

Kedilerde Sakroiliak Luksasyonun Vida Fiksasyonu ile Tedavisinin Pelvik Kanal Genişliği Oranına Etkisinin Araştırılması

Öz

Bu çalışmanın amacı, travmalar sonucu sakroiliak çıkık gelişen kedilerde, vida stabilizasyonunun iki ilium arası mesafe, pelvik kanal genişliği ve hemipelvik kanal oranları üzerindeki etkilerini pre ve postoperatif olarak değerlendirmektir. Bu çalışmada 2023-2024 yılları arasında Selçuk Üniversitesi, Küçük Hayvan Hastanesi’ne travma sonucu sakroiliak çıkık oluşan ve cerrahi girişim gerçekleştirilen farklı ırk, cinsiyet, yaş, ağırlıkta 18 kedi oluşturdu. Klinik, hemogram ve radyolojik muayeneleri yapıldı. Operasyon öncesi medikal tedaviye ihtiyaç duyan hastaların rehabilitasyonlarından sonra sakroiliak çıkıklarda ilium ile sakrum arasında vida stabilizasyonu yapıldı. 18 olgunun %16.6’sında bilateral sakroiliak çıkık, %16.6’sında sakroiliak çıkık beraberinde ilium kırığı, %16.6’sında sakroiliak çıkık beraberinde ischii kırığı, %11.1’inde sakroiliak çıkık beraberinde pubis kırığı, %11.1’inde sakroiliak çıkık beraberinde pubis ve ischii kırığı, %5.6’sında sakroiliak çıkık beraberinde acetabulum kırığı, %5.6’sında sakroiliak çıkık beraberinde acetabulum ve ilium kırığı, %5.6’sında sakroiliak çıkık beraberinde ilium ve ischii kırığı, %5.6’sında sakroiliak çıkık beraberinde pubis ile ilium kırığı ve caput femoris luksazyonu, %5.6’sında sakroiliak çıkık beraberinde pubis, ilium, ischii ve symphysis pelvina kırığı olduğu belirlendi. Sakroiliak çıkık teşhisi konulan ve cerrahi girişim uygulanan 18 olgunun %84’ünde operasyon sonrası pelvik kanal genişliği oranı (PKGO)≥1.1 olarak bulunmuştur. Cerrahi girişim öncesi ve sonrası iki ilium arası oran arasında ve pelvik kanal oranı arasında istatistiksel olarak anlamlı bir fark gözlenmedi. Ancak, operasyon öncesi ve sonrası hemipelvik kanal oranı arasında istatistiksel olarak anlamlı bir fark olduğu belirlendi (p<0.05). Yapılan çalışmada pre ve postoperatif sonuçlarının karşılaştırılmasında, iki ilium arası, pelvik kanal ve hemipelvik kanal oranları post-op dönemde sağlıklı anatomik yapıya yaklaştığı gözlendi. Seçilecek cerrahi teknikte, olguların ilium body’a dorsal yaklaşım ile açığa çıkarılması uygulama kolaylığı sağlamıştır.

Anahtar Kelimeler

• Hemipelvik kanal oranları
• ilium mesafesi
• pelvik kanal oranları
• vida fiksasyonu

Kaynakça

1. Bookbinder PE, Flanders JA (1992). Characteristics of pelvic fracture in the cat: A 10-year retrospective study. Vet Comp Orthop Traumatol., 5(3):122-127.
2. Burger M, Forterre F, Brunnberg L (2004). Surgical anatomy of the feline sacroiliac joint for lag screw fixation of sacroiliac fracture-luxation. Vet Comp Orthop Traumatol., 17:146-151.
3. Meeson RL, Geddes AT (2017). Management and long-term outcome of pelvic fractures: A retrospective study of 43 cats. J Feline Med Surg.,19:36-41.
4. DeCamp CE, Johnston SA, Dejardin LM (2016). Brinker. Piermattei and Flo’s handbook for small animal orthopaedics and fracture repair. In: Feline sacroiliac joint for lag screw fixation of sacroiliac fracture-luxation. DeCamp CE. Johnston SA (eds). 5th ed. Saunders Elsevier. Missouri. USA., 146-155.
5. Anderson A, Coughlan AR (1997). Sacral fractures in dogs and cats: A classification scheme and review of 51 cases. J Small Anim Pract., 38:404-409.
6. Hulse DA, Shires P, Waldron D (1985). Sacroiliac luxations. Compend Contin Educ Pract Vet., 7:493-499.
7. Grierson J (2019). Dealing with pelvic fractures in cats. In practice Companion Anim Prac., 41(3):106-114.
8. Zamirbekova N, Uzunlu EO, Özdil B, Arıcan M (2021). Kedilerde corpus ossis ilium kırıklarının sağaltımında kemik plakların os ilium‟un lateral ve dorsal yüzüne uygulamasının klinik ve radyolojik olarak karşılaştırılması. Eurasian J Vet Sci., 37(1):32-40.

9. Arıcan M (2024). Anatomik bölgelere cerrahi yaklaşımlar. (İçinde): Kedi ve köpek Ortopedi ve Travmatoloji. 2.Baskı. Anka Promosyon Matbaa Mlz. Ltd. Şti., Konya., 131-174.
10. Messmer M, Montavon PM (2004). Pelvic fractures in the dog and cat: A classification system and review of 556 cases. Vet Comp Orthop Traumatol., 17:167-83.
11. Meeson R, Corr S (2011). Management of pelvic trauma. Neurological damage. urinary tract disruption and pelvic fractures. J Feline Med Surg., 13:347-61.
12. Averill SM, Johnson AL, Schaeffer DJ (1997). Risk factors associated with development of pelvic canal stenosis secondary to sacroiliac separation: 84 cases (1985-1995). J Am Vet Med Assoc., 211:75-78.
13. Voss K. Langley-Hobbs SJ. Borer L (2009). Pelvis. In: Feline orthopaedic surgery and musculoskeletal disease. Montavon PM. Voss K. Langley-Hobbs SJ (eds). 1th ed. Elsevier Saunders. Edinburgh., 423-430.
14. Bennett D (1975). Orthopaedic disease affecting the pelvic region of the cat. J Small Anim Pract., 16:723-738.
15. Lanz OI (2002). Lumbo sacral and pelvic injuries. Vet Clin North Am Small Anim Pract., 32(4):949-62.
16. Schrader SC (1992). Pelvic osteotomy as a treatment for obstipation in cats with acquired stenosis of the pelvic canal: six cases (1978-1989). J Am Vet Med Assoc., 200:208-13.
17. Langley-Hobbs SJ (2010). Sacroiliac luxation in cats. Proceedings of the ACVS veterinary symposium; 2010 Oct 18-23; Seattle. WA. Washington. DC: American College of Veterinary Surgeons, 326-329.
18. Moens NMM DeCamp CE (2018). Fractures of the pelvis. In: Veterinary Surgery: Small Animal. Johnston SA. Tobias KM (eds). 2nd ed. Elsevier. St Louis., 938-56.
19. Stecyk CN, Jones SC, Hostnik ET, Tinga S, Kieves NR (2021). Conservative management of sacroiliac luxation in 17 dogs: radiographic changes and long-term owner follow-up. Can Vet J., 62(03):261-265.
20. Yap FW, Dunn AL, Farrell M (2014). Trans-iliac pin/bolt/screw internal fixation for sacroiliac luxation or separation in cats: six cases. J Feline Med Surg.,16:354-362.
21. Pratesi A, Grierson JM, Moores AP (2018). Single transsacral screw and nut stabilization of bilateral sacroiliac luxation in 20 cats. Vet Comp Orthop Traumatol., 31:44-52.
22. Yap FW, Dunn AL, Garcia-Fernandez PM (2015). Femoral head and neck excision in cats: medium to long-term functional outcome in 18 cats. J Feline Med Surg., 17: 704-710.
23. Fisher CJ, Cavanagh AA, Liss D, Adams T, Marvel SJ, Hall KE (2023). Surgical interventions and outcome in a population of feline trauma patients. J Vet Emerg Crit Care.,33(3):337-347.
24. Montavon PM, Boudrieau RJ, Hohn RB (1985). Ventrolateral approach for repair of sacroiliac fracture-dislocation in the dog and cat. J Am Vet Med Assoc., 186:1198-2001.
25. Tomlinson J (2020). Minimally Invasive Repair of Sacroiliac Luxation. Vet Clin North Am Small Anim Pract., 50(1):231-239.
26. Boehmer E (1985). Beckenfrakturen und -luxationen bei der Katze in den Jahren 1975-1982. Vet Med Dissertation.,151.
27. Raffan PJ, Joly CL, Timm PG (2002). A tension band technique for stabilisation of sacroiliac separations in cats. J Small Anim Pract., 43:255-260.
28. Tomlinson J (2012). Minimally invasive repair of sacroiliac luxation in small animals. Vet Clin North Am Small Anim Pract., 42:1069-1077.
29. Couper E, De Decker S (2020). Evaluation of prognostic factors for return of urinary and defecatory function in cats with sacrocaudal luxation. J Feline Med Surg., 22(10):928-934.
30. Bird FG, Vicente F (2020). Conservative management of sacroiliac luxation fracture in cats: medium- to long-term functional outcome. J Feline Med Surg., 22(6):575-581.
31. Philp H, Durand A, De Vicente F (2018). Use of computed tomogra¬phy to define a sacral safe corridor for placement of 2.7 mm cortical screws in feline sacroiliac luxation. J Feline Med Surg., 20(6):487-493.
32. Hanlon J, Hudson CC, Litsky AS, Jones SC (2022). Mechanical evaluation of canine sacroiliac joint stabilization using two short screws. Vet Surg., 51(7):1061-1069.
33. Çatalkaya E, Yayla S, Altan S, Ersöz Kanay B, Saylak N, Hatipoğlu Ş (2024). A Retrospective Study on Pelvic Fractures in Cats and Dogs (2020-2022). Kocatepe Vet J., 17(1):15-21.
34. Tomlinson JL (2003). Fractures of the pelvis, in: Textbook of Small Animal Surgery. Slatter D (ed). 3rd ed. Saunders. Philadelphia. PA.,1189-2001.
35. Schreiber KRL, Thibault A, Hamon M, Haudiquet P (2024). Stabilization of 82 sacroiliac luxations in 67 cats using two sacroiliac screws (2014-2023). Vet Surg.. 53(8):1366-76.
36. Kudnig ST, Fitch RB (2004). Trans-ilial and transsacral brace fixation of sacral fractures and sacroiliac luxations seven cases. Vet Comp Orthop Traumatol., 17:210.
37. Leasure CS, Lewis DD, Sereda CW (2007). Limited open reduction and stabilization of sacroiliac fracture-luxations using fluoroscopically assisted placement of a trans-iliosacral rod in five dogs. Vet J., 36:633-643.