Navigation-aided visualization of lumbosacral nerves for anterior sacroiliac plate fixation: a case report

Anterior sacroiliac joint plate fixation for unstable pelvic ring fractures avoids soft tissue problems in the buttocks; however, the lumbosacral nerves lie in close proximity to the sacroiliac joint and may be injured during the procedure.

A 49 year-old woman with a type C pelvic ring fracture was treated with an anterior sacroiliac plate using a computed tomography (CT)-three-dimensional (3D)-fluoroscopy matching navigation system, which visualized the lumbosacral nerves as well as the iliac and sacral bones. We used a flat panel detector 3D C-arm, which made it possible to superimpose our preoperative CT-based plan on the intra-operative 3D-fluoroscopic images.

No postoperative complications were noted.

Intra-operative lumbosacral nerve visualization using computer navigation was useful to recognize the 'at-risk' area for nerve injury during anterior sacroiliac plate fixation.