Is the Iliac Cortical Density Similarly Positioned in the Developing Pediatric Pelvis?

Related Experiment Video

Updated: Nov 5, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
07:41

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse

Published on: April 17, 2019

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Benjamin F Watzig1, Danielle F Peterson1, Austin R Thompson1

  • 1Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR; and.

Journal of Orthopaedic Trauma
|May 16, 2021
PubMed

Insights

The iliac cortical density (ICD) is a reliable landmark for pediatric pelvic screw placement. Osseous pathways for iliosacral (IS) and transiliac-transsacral (TSTI) screws widen with age in non-dysmorphic pelvises, but remain narrow in younger or dysmorphic cases.

Area of Science:

  • Pediatric Orthopedics
  • Surgical Anatomy
  • Medical Imaging

Background:

  • The iliac cortical density (ICD) is a key fluoroscopic landmark for pelvic percutaneous screw placement.
  • Evaluating its utility in pediatric populations is crucial for surgical planning.

Purpose of the Study:

  • To assess the iliac cortical density (ICD) as a landmark in pediatric patients.
  • To quantify osseous pathway diameters for iliosacral (IS) and transiliac-transsacral (TSTI) screw trajectories at S1 and S2 levels.

Main Methods:

  • Analysis of 267 pediatric pelvic CT scans (ages 0-16).
  • Measurement of ICD and S1 vertebral heights.
  • Comparison of osseous screw corridor dimensions across age groups and dysmorphic status.

Main Results:

  • In non-dysmorphic pelvises, ICD height, S1 height, and their ratio increased significantly with age.
  • All three screw pathway diameters (IS at S1, TSTI at S1, TSTI at S2) enlarged with age in non-dysmorphic cases.
  • Dysmorphic pelvises showed no age-related increase in the ICD to S1 height ratio, with narrower S1 TSTI pathways.

Conclusions:

  • The ICD is a valuable fluoroscopic landmark for pediatric pelvic percutaneous screw placement.
  • Osseous corridors for IS and TSTI screws increase with age in non-dysmorphic pediatric pelvises.
  • Younger and dysmorphic pediatric pelvises present a smaller margin for safe screw placement.
Abstract

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