Reconstruction of Shattered Lumbo-Sacral Junction/Pelvis Utilizing Bilateral L4-Sacrum Fibula Strut Allograft And Double Iliac Screws Plus Routine Lumbar Pedicle Screw Fixation
| Autor: | Marc Agulnick, Benjamin R Cohen, Nancy E Epstein |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Sacral screws Nonunion Pedicle screws Sacral disruption 03 medical and health sciences Sacral fracture 0302 clinical medicine Lumbar Bypass lumbar fracture Ischial fusion Medicine Joint dislocation Fibula Pedicle screw Pelvis Sacroiliac joint dislocation business.industry Fibula allograft equipment and supplies musculoskeletal system Sacrum medicine.disease Surgery surgical procedures operative medicine.anatomical_structure 030220 oncology & carcinogenesis Neurology (clinical) Technical Notes Reconstruction business 030217 neurology & neurosurgery Lumbosacral joint |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 |
| DOI: | 10.25259/sni_326_2020 |
| Popis: | Background: A traumatically shattered lumbosacral junction/pelvis may be difficult to repair. Here the authors offer a pelvic fixation technique utilizing routine pedicle screws, interbody lumbar fusions, bilateral iliac screws/ rods/crosslinks, and bilateral fibular strut allografts from the lumbar spine to the sacrum. Methods: A middle aged male sustained a multiple storey fall resulting in a left sacral fracture, and right sacroiliac joint (SI) dislocation. The patient had previously undergone attempted decompressions with routine pedicle screw L4-S1 fusions at outside institutions; these failed twice. When the patient was finally seen, he exhibited, on CT reconstructed images, MR, and X-rays, a left sacral fracture nonunion, and a right sacroiliac joint dislocation. Results: The patient underwent a bilateral pelvic reconstruction utilizing right L4, L5, S1 and left L4, L5 pedicle screws plus interbody fusions (L4-L5, and L5, S1), performed from the left. Unique to this fusion construct was the placement of bilateral double iliac screws plus the application of bilateral fibula allografts from L4-sacrum filled with bone morphogenetic protein (BMP). After rod/screw/connectors were applied, bone graft was placed over the fusion construct, including the decorticated edges of the left sacral fractures, and right SI joint dislocation. We additionally reviewed other pelvic fusion reconstruction methods. Conclusions: Here, we utilized a unique pelvic reconstruction technique utilizing pedicle screws/rods, double iliac screws/rods, and bilateral fibula strut grafts extending from the L4-sacrum filled with BMP. |
| Databáze: | OpenAIRE |
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