Abstract
ABSTRACT Sacropelvic fixation arose from the need to protect the sacral instrumentation in long constructions, due to failures in the implant-bone interface and the treatment of diseases in which there is no possibilities of sacral fixation such as infections and tumors. Due to anatomic difficulties and the complex spinopelvic biomechanics several techniques were developed. The fixation with iliac screws has become according to multiple studies, a well-established technique that minimizes frequent complications such as pseudoarthrosis and implant failure. However, it has disadvantages such as iliac wing fracture and skin lesions due to the protrusion of materials. The present study aims to comprehensively review the literature on the technique taking into account relevant aspects to its better knowledge and application. Level of evidence III; Therapeutic Study.
Highlights
Sacropelvic fixation arose from the need to protect the sacral instrumentation in long constructions, due to failures in the implant-bone interface and the treatment of diseases in which there is no possibilities of sacral fixation such as infections and tumors
The fixation with iliac screws has become according to multiple studies, a well-established technique that minimizes frequent complications such as pseudoarthrosis and implant failure
The first spinal instrumentation techniques developed for pelvic fixation date from the 1970s when Luque developed multiple sublaminar fixation using wires connected to a rod in the shape of an L to prevent its rotation.[1]
Summary
The first spinal instrumentation techniques developed for pelvic fixation date from the 1970s when Luque developed multiple sublaminar fixation using wires connected to a rod in the shape of an L to prevent its rotation.[1] Later, in 1976, Allen and Ferguson described their experience with the Galveston technique.[2] This technique involved the implantation of L-shaped rods, differentiated in their distal portion, anchored between the internal and external tables of the ilium. With advances in instrumentation and the development of fixation using Cotrel-Dubousset rods, sacropelvic fixation began to be performed using hooks and pedicle screws,[2] implemented for the first time in 1973 by Vidal and later modified by Dubousset and Farcy.[3]. Despite the advances in surgical techniques, arthrodesis of the lumbosacral junction remains a challenge with high failure rates, mainly in cases that require treatment using long constructions.[4]. Several aspects contribute to the difficulty in successful treatment
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