Morphometry of the sacrum and its implication on trans-sacral corridors using a computed tomography data-based...

Area of Science:

• Orthopedic surgery
• Anatomical studies
• Medical imaging

Background:

• Trans-sacral implants are vital for treating sacral fractures, particularly in osteoporotic patients.
• Sacral anatomy's complexity and variability pose challenges for implant placement.
• Critical morphologic factors influencing trans-sacral corridor dimensions remain unclear.

Purpose of the Study:

• To assess sacral anatomy and its impact on trans-sacral corridor dimensions.
• To identify key morphologic characteristics that determine trans-sacral corridor availability.

Main Methods:

• Utilized computed tomography (CT) data from 92 intact pelvises to create a 3D statistical size and shape model of the sacrum.
• Performed morphometric measurements of the sacrum and trans-sacral corridors.
• Analyzed shape and size variations using principal component analysis and regression.

Main Results:

• Trans-sacral corridor diameters varied, with S1 averaging 13.1 mm (±5 mm) and S2 averaging 13.8 mm (±2.4 mm).
• Sacral curvature, pelvic incidence, and auricular surface position significantly influenced S1 corridor dimensions.
• Sacral shape variability impacts corridor size, highlighting the importance of auricular surface position and sacral ala shape.

Conclusions:

• Human sacral anatomy exhibits significant size and shape variability.
• Trans-sacral corridor dimensions are directly influenced by sacral shape and specific morphologic features.
• Thorough preoperative assessment of morphologic variants is mandatory for safe and effective trans-sacral implant procedures.