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Spinopelvic Fixation.

Sean M Esmende1, Kalpit N Shah, Alan H Daniels

  • 1From the Orthopedic Associates of Hartford and the Bone and Joint Institute at Hartford Hospital, Hartford, CT (Dr. Esmende), and the Warren Alpert Medical School at Brown University and the Department of Orthopedic Surgery, Rhode Island Hospital, Providence, RI (Dr. Shah and Dr. Daniels).

The Journal of the American Academy of Orthopaedic Surgeons
|May 5, 2018
PubMed
Summary
This summary is machine-generated.

Fixing the lumbosacral junction remains difficult for spine surgeons due to poor bone quality and biomechanical forces. Understanding spinopelvic fixation techniques is crucial for complex spinal reconstructions to minimize complications.

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Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Fixation at the lumbosacral junction presents significant challenges for spine surgeons.
  • Poor sacral bone quality, complex anatomy, and high biomechanical forces increase instrumentation complication rates.
  • Many spinopelvic fixation techniques exist, but few are widely adopted due to high complication rates.

Purpose of the Study:

  • To review the challenges and techniques of spinopelvic fixation.
  • To highlight the indications for spinopelvic fixation.
  • To inform surgeons about available techniques, risks, and complications in complex spinal reconstruction.

Main Methods:

  • Review of existing literature on spinopelvic fixation techniques.
  • Analysis of biomechanical factors influencing lumbosacral junction fixation.
  • Discussion of common indications and associated complications.

Main Results:

  • Lumbosacral junction fixation is complex, with high complication rates.
  • Long-segment lumbar/thoracolumbar fusions to the sacrum are common indications.
  • A limited number of spinopelvic fixation techniques are currently favored due to safety and efficacy.

Conclusions:

  • Surgeons must be familiar with various spinopelvic fixation methods.
  • Awareness of potential risks and complications is essential for successful outcomes.
  • Advances in spinal instrumentation aim to improve fixation and reduce complications at the lumbosacral junction.