Spinopelvic Fixation

유창훈; 양재준; 장봉순

Lumbosacral fixation or spinopelvic fixation is frequently required for the surgical treatment of neuromuscular scoliosis and degenerative lesions, trauma and tumor in the lumbosacral vertebrae. However, the establishment of stable fixation with these procedures is difficult due to the anatomic characteristics of the sacrum and this is even more problematic for the cases with long segmental fixation, severe instability and bone defects. Although the emergence of pedicle screws makes spinal fixation easier and more rigid, S1 pedicle screws alone do not provide enough stability for lumbosacral fixation. For the purposes of reinforcing lumbosacral fixation, procedures using rods or screws can be used: the procedures using rods include the Galveston method, the McCarthy S-rod and the Jackson intrasacral rod, and the procedures using screws include sacral alar screws, transdiscal screws and iliac screws. The purpose of this study was to ascertain the proper fixation methods, according to each indication, for spinopelvic fixation and we analyzed the advantages and drawbacks of each fixation method. In addition, the fixation method of iliac screws, which has recently become more popular, is presented in detail to enhance the availability and reduce the complication of this technique.

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REFERENCES (23)
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* 2021년 이후 발행 논문의 참고문헌은 현재 구축 중입니다.

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[journal] Allen BI / 1982 / The Galveston technique for Lrod instrumentation of the scoliotic spine / Spine 7 : 276~284

[journal] McCord DH / 1992 / Biomechanical analysis of lumbosacral fixation / Spine 17 : 235~243

[journal] Camp JF / 1990 / Immediate complication of Cotrel-Dubousset instrumentation to the sacro-pelvis: A clinical and biomechanical study / Spine 15 : 932~941

[journal] Yazici M / 2000 / The safety and efficacy of Isola-Galveston instrumentation and arthrodesis in the treatment of neuromuscular spinal deformities / J Bone Joint Surg Am 82 : 524~543

[journal] McCarthy RE / 1989 / Luque fixation to the sacral alar using the Dunn-McCarthy modification / Spine 14 : 281~284

[journal] Walick KS / 2008 / Neuropathic lower extremity pain following Dunn-McCarthy Instrumentation / Spine 33 : 877~880

[journal] Peelle MW / 2006 / Comparison of pelvic fixation techniques in neuromuscular spinal deformity correction: Galveston rod versus iliac and lumbosacral screws / Spine 31 : 2392~2398

[journal] Tsuchiya K / 2006 / Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity / Spine 31 : 303~308

[journal] Kostuik JP / 1998 / Biomechanical testing of the lumbosacral spine / Spine 23 : 1721~1728

[journal] Jackson RP / 1993 / The iliac buttress. A computed tomographic study of sacral anatomy / Spine 18 : 1318~1328

[journal] Minamide A / 2003 / Transdiscal L5-S1 screws for the fixation of isthmic spondylolisthesis: A biomechanical evaluation / J Spinal Disord 16 : 144~149

[journal] Farcy W / 1992 / Technique and results of fixation to the sacrum with iliosacral screw / Spine 17 : 190~195

[journal] Routt MLC / 2000 / Percutaneous fixation of pelvic ring disruptions / Clin Orthop Relat Res 375 : 15~29

[book] Asher MA / 1996 / Lumbopelvic fixation with the Isola spinal implant system. (in: Lumbosacral and spinopelvic fixation) / Lippincott-Raven : 215~

[journal] Phillips JH / 2007 / Iliac screw fixation in neuromuscular scoliosis / Spine 32 : 1566~1570

[journal] Zhang HY / 2003 / Surgical technique for total sacrectomy and spinopelvic reconstruction / Neurosurg Focus 15 : 5~14

[journal] O’Brien JR / 2009 / An anatomic study of the S2 iliac technique for lumbopelvic screw placement / Spine 34 : 349~442

[journal] Chang TL / 2009 / Low profile pelvic fixation: Anatomical parameters for sacral alar-iliac fixation versus traditional iliac fixation / Spine 34 : 436~440

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