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Spinopelvic Dissociation: A Systematic Review and Meta-analysis
Henrik C Bäcker1, J Turner Vosseller, Moritz C Deml
1From the Department of Orthopaedic Surgery (Dr. Bäcker, Dr. Vosseller), Columbia University Medical Center, New York City, NY, the Center for Musculo-Skeletal Surgery (Dr. Bäcker, Dr. Perka, Dr. Putzier), Charité-Universitätsmedizin Berlin, Berlin, Germany , and the Department of Orthopaedic Surgery and Traumatology, (Dr. Deml) Inselspital, University Hospital Bern, Bern, Switzerland.
Spinopelvic dissociation is a rare, high-energy trauma injury. Surgery offers a 100% fusion rate, but complications occur in nearly 30% of patients, suggesting a need for improved treatment algorithms.
Area of Science:
- Orthopedics
- Trauma Surgery
- Spinal Surgery
Background:
- Spinopelvic dissociation is a rare injury (2.9% of pelvic disruptions), often resulting from high-energy trauma.
- Limited data exists, necessitating a comprehensive review of existing literature.
Purpose of the Study:
- To systematically evaluate the incidence, demographics, treatment, outcomes, and complications of spinopelvic dissociation injuries.
Main Methods:
- Systematic literature review of Medline, PubMed, and Google databases.
- Inclusion of 50 articles from 216 reviewed abstracts, predominantly case reports and series.
- Analysis of data from 379 patients identified between 1969 and 2018.
Main Results:
- Most injuries resulted from falls (55.7%) or road accidents (28.5%).
- 68.1% of patients presented with neurologic impairment, improving in 65.1% post-surgery.
- Surgery (93.1%) with triangular fixation (68.8%) yielded a 100% healing/fusion rate, with a 29.9% complication rate.
Conclusions:
- Spinopelvic dissociation is a rare injury with scarce literature, highlighting the need for evidence-based guidelines.
- A streamlined, evidence-based algorithm could potentially enhance patient care for these complex injuries.
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