THE IMPORTANCE OF SACRUM MORPHOLOGY IN TRANSSACRAL AND ILIOSACRAL SCREW FIXATION


Durusoy S. , Paksoy A. E.

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol.23, no.1, pp.59-67, 2021 (National Refreed University Journal)

  • Publication Type: Article / Article
  • Volume: 23 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.24938/kutfd.816996
  • Title of Journal : Kırıkkale Üniversitesi Tıp Fakültesi Dergisi
  • Page Numbers: pp.59-67

Abstract

Objective: In this study, it was aimed to put forward the effects of the morphological characteristics of the sacrum on the choice of iliosacral or transsacral screwing. Material and Methods: The study was carried out on 224 patients who underwent computerized tomographic imaging of the pelvis between May 2016 and May 2019. By reviewing the images of the patients, parameters such as sacrum types, applicability for transsacral screwing, the narrowest diameter of the bone corridor in the coronal plane where the screw was placed properly, and the anteversion angle of the screw were evaluated. Moreover, the distribution of these data according to age and gender was compared between the groups. Results: Of the patients' sacrums; 72 (32.1%) were the ascending type, 28 (12.5%) were the descending type, 106 (47.3%) were the horizontal type, and 18 (8%) were the dysmorphic type. While transsacral screwing could be performed in 136 (60%) of the sacrums, it was not possible in 88 (40%). The width of the narrowest part where the iliosacral screw would pass was 19.52 (52 (min-max:11.8-47)) mm on average in all patient groups. There was no difference only between the horizontal and the descending types in terms of the narrowest diameter through which the iliosacral screw would pass. The anteversion angle of the iliosacral screw was 25.4 (min-max:5-52.5) degrees on average in all patients. The anteversion angle of the iliosacral screw varied between all sacrum types. Conclusion: Differences in the sacrum morphology in patients who will undergo iliosacral or transsacral screwing affect the choice of surgery to be applied. For this reason, preoperative surgical planning is essential according to the sacrum morphology.