J Korean Orthop Assoc.  2016 Jun;51(3):221-230. 10.4055/jkoa.2016.51.3.221.

Lumbopelvic Fixation with Iliac Screw in Spinopelvic Dissociation

Affiliations
  • 1Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea. hjkim@eulji.ac.kr

Abstract

PURPOSE
Spinopelvic dissociation which occurs by high energy trauma with associated fractures is rare. Treatment is difficult and only a few studies on treatment of spinopelvic dissociation have been reported. Therefore we evaluated spinopelvic dissociation patients treated with iliac screw.
MATERIALS AND METHODS
We analyzed patients who underwent surgery using an iliac screw from 2005 to 2010. Preoperative radiologic classification was performed using the level of the transverse fracture line of the sacrum, shape of the fracture, and Roy-Camille classification. Neurologic evaluation was performed using Gibbons classification. Eleven patients underwent surgery with a pedicle screw in 1 level (L5 to S1) and bilateral iliac screws were added.
RESULTS
A total of 11 patients were included in this study. The level of the transverse fracture line of the sacrum was mainly at S2, and there were mostly type 3 or 4 in Roy-Camille classification. Bony union was checked in 11 patients without metal failure. Six of 7 patients were treated by posterior decompression. Among them, 5 patients recovered from neurological deficit and 1 patient still had a sensory disorder on both lower legs.
CONCLUSION
The more displacement of fracture, the more neurologic deficit occurred. In addition, we think that aggressive surgical treatment for spinopelvic dissociation should be considered, because a good clinical result was achieved with 1 level (L5 to S1) fixation and bilateral iliac screw fixation.

Keyword

spinopelvic dissociation; iliac screw; sacral fracture
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