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Defining Sacral Dysmorphism: What Size Corridor Precludes Transsacral Screw Placement.

David Woods1, Jason Koerner1, Katya Strage2

  • 1Department of Orthopaedics, University of Colorado School of Medicine, Denver, CO.

Journal of Orthopaedic Trauma
|April 22, 2022
PubMed
Summary
This summary is machine-generated.

The S1-transsacral (TS) corridor size is crucial for TS screw placement in pelvic ring injuries. Narrower corridors (<8 mm) were common and not linked to gender or ethnicity, with screw breaches occurring regardless of corridor width.

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Area of Science:

  • Orthopedic surgery
  • Radiology
  • Anatomy

Background:

  • Pelvic ring injuries often require surgical fixation.
  • Percutaneous posterior pelvic ring fixation utilizes S1-transsacral (TS) screws.
  • Sacral dysmorphism assessment can be informed by TS corridor dimensions.

Purpose of the Study:

  • To define the minimum S1-TS corridor width amenable to TS screw placement.
  • To investigate the association between corridor size and factors like gender, ethnicity, and screw breach.
  • To establish standardized reporting for sacral dysmorphism based on corridor measurements.

Main Methods:

  • Retrospective review of 290 patients with pelvic ring injuries and preoperative CT scans.
  • Measurement of S1-TS corridor width on axial and coronal CT reformats.
  • Analysis of S1-TS screw placement, corridor size, gender, ethnicity, and screw breach in 55 patients.

Main Results:

  • No S1-TS screws were placed in corridors less than 8 mm.
  • Corridors <8 mm were present in 39% of patients, unrelated to gender or ethnicity.
  • Screw breaches occurred in 62% of screws placed in small (<10 mm) corridors versus 40% in large (≥10 mm) corridors, with no significant difference in breach distance.

Conclusions:

  • The S1-TS corridor size is a key factor for safe screw placement, with 8 mm as a potential minimum threshold.
  • Sacral dysmorphism reporting can be standardized using corridor size, independent of gender or ethnicity.
  • High rates of screw breach underscore the precision required for TS screw fixation, irrespective of corridor width.