Anatomy of the sacroiliac joint with relation to the lumbosacral trunk: Is there sufficient space for a two-hole plate?


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 05 05 2023
accepted: 25 09 2023
medline: 23 10 2023
pubmed: 19 10 2023
entrez: 19 10 2023
Statut: epublish

Résumé

Dislocations of the sacroiliac joint (SIJ) are treated with iliosacral screws or anterior plating. The study aimed to investigate the course of the lumbosacral trunk with reference to SIJ and determine whether is there sufficient space for two screws through the sacrum while performing anterior plating. Sixty patients, who underwent an MRI of the lumbar spine were included in our study. The three transverse LT-SIJ distances were measured at the three points (A, B, and C). We also analyzed 60 CT pelvic scans at points A, B, and C in order to measure: the vertebral canal-to-SIJ distance, the sacrum's pelvic-to-dorsal surface sagittal distance, and the median plane-to-SIJ angle. The mean transverse LT-SIJ distances at points A, B, and C were 20.0 ± 3.05 mm, 17.9 ± 3.20 mm, and 12.3 ± 2.49 mm, respectively. Based on CT analyses, the vertebral canal-to-SIJ distances were 30.5 ± 7.65 mm at point A, 21.4 ± 5.05 mm at point B and 15.7 ± 6.05 mm at point C. The sacrum's pelvic-to-dorsal surface sagittal distances reached values: 35.1 ± 11.62 mm at point A, 52.5 ± 10.58 mm at point B, and 57.5 ± 7.79 mm at point C. The median plane-to-SIJ angles measured 31.4 ± 4.82 degrees at point A, 26.6 ± 3.77 degrees at point B and 21.3 ± 3.25 mm at point C. Proximally, the safe zone for applying an anterior plate of SIJ is 20.0 mm. Since both the safe zone and safe corridor taper distally, surgeons may securely use one screw of gradually increased length towards the distal direction of SIJ, with inclination of 30 degrees in relation to the median plane of the lesser pelvis.

Identifiants

pubmed: 37856449
doi: 10.1371/journal.pone.0292620
pii: PONE-D-23-12874
pmc: PMC10586703
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0292620

Informations de copyright

Copyright: © 2023 Kułakowski et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Michał Kułakowski (M)

Orthopaedic and Trauma Surgery Department, Independent Public Healthcare Center Rypin, Rypin, Poland.

Karol Elster (K)

Orthopaedic and Trauma Surgery Department, Independent Public Healthcare Center Rypin, Rypin, Poland.

Paweł Reichert (P)

Clinical Department of Trauma and Hand Surgery, Jan Mikulicz-Radecki University Clinical Hospital in Wroclaw, Wroclaw, Poland.

Aleksandra Królikowska (A)

Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.

Joanna Jerominko (J)

Department of Radiology, Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.

Paweł Ślęczka (P)

Orthopaedic and Trauma Surgery Department, Independent Public Healthcare Center Myślenice, Myślenice, Poland.

Magdalena Grzonkowska (M)

Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toruń, Toruń, Poland.

Michał Szpinda (M)

Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toruń, Toruń, Poland.

Mariusz Baumgart (M)

Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toruń, Toruń, Poland.

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Classifications MeSH