Minimally Invasive and Navigation-Assisted Fracture Stabilization Following Traumatic Spinopelvic Dissociation

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Minimally Invasive Surgical Techniques

Background:

• Spinopelvic dissociation is a severe orthopedic injury with increasing global incidence.
• Traditional open surgical treatment involves extensive lumbopelvic fusion and sacroiliac stabilization, associated with significant perioperative risks, especially in vulnerable patients.
• Minimally invasive surgery (MIS) offers a less invasive alternative.

Purpose of the Study:

• To review current concepts in spinopelvic anatomy and fracture patterns.
• To discuss indications for operative treatment of spinopelvic dissociation.
• To present current concepts and illustrative examples of minimally invasive percutaneous lumbopelvic fixation.

Main Methods:

• Utilizes advancements in spinal navigation, robotics, and MIS for percutaneous pedicle screw and iliac fixation.
• Employs modern imaging, including CT navigation and robotics, for precise S2AI screw placement.
• Contrasts percutaneous techniques with traditional open midline approaches, highlighting differences in dissection and blood loss.

Main Results:

• Minimally invasive percutaneous techniques allow for treatment through small incisions, reducing soft tissue dissection and blood loss.
• Advanced imaging facilitates accurate screw placement, safely navigating around existing hardware.
• MIS techniques are associated with faster postoperative rehabilitation, decreased pain, and quicker patient mobilization.

Conclusions:

• Minimally invasive percutaneous lumbopelvic fixation is a viable and advantageous alternative to open surgery for spinopelvic dissociation.
• MIS techniques offer significant benefits including reduced morbidity, faster recovery, and improved patient outcomes.
• Continued adoption of MIS and advanced navigation technologies will likely shape the future treatment of these complex injuries.