Morphometric anatomical and CT study of the human adult sacroiliac region

Postacchini, Roberto; Trasimeni, G.; Ripani, Francesca Romana; Sessa, Pasquale; Perotti, Stefano; Postacchini, Franco

doi:10.1007/s00276-016-1703-0

Cited by 19 publications

(19 citation statements)

References 30 publications

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“…The tongue-in-groove interosseous interdigitations featuring in the retro-articular part of SIJ articulations are constant features of normal and dysmorphic LSTV variations. 6,29,31,34 As observed in this study, identifying the type of AS position may be a good indicator to assess the obliquity and of the upper 2 sacral segments. It will be worth mentioning here that individual 3-dimensional reconstruction of lumbosacral computed tomography (CT) gives accurate casebased anatomical information in patients.…”

Section: ) Sacralizationmentioning

confidence: 56%

“…[1][2][3][4][5] However, the biomechanical importance LSTV-related alterations at the sacroiliac articular symmetry, facet dimensions, and associated lumbosacral anatomy have been relatively underreported. [6][7][8][9] The 2 classification systems currently available to characterize LSTV focus only at the lumbosacral junction. 10,11 Consequently, these classification systems do not recognize associated morphological alterations that accompany LSTV variations including the change in the number of sacral segments and lumbar vertebrae, asymmetries of load-bearing surfaces and facet dimensions, and overall sacral anatomy that result from inclusion or exclusion of vertebral segments into the sacral mass.…”

Section: Introductionmentioning

confidence: 99%

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Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

Mahato

2020

Neurospine

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Objective: Although a wide range of sacral dysmorphisms has been documented with lumbosacral transitional vertebrae (LSTV) variations, quantitative characterization of the upper segment morphology and articular anatomy across the array of lumbosacral transitions are hardly found in the literature. This study presents LSTV anomalies as a series of sequential morphological changes (the LSTV spectrum) and quantitatively compares 6 LSTV subtypes with normative sacral dimensions including the anatomy at the upper sacral segments used for percutaneous sacroiliac screw insertion. Methods: Seven linear dimensions were measured from LSTV subtypes and normal sacral variants from dried adult sacral specimens. The auricular, superior articular and facet surface areas were quantified. Obliquity and thickness of osseous corridors used for sacroiliac screw fixation were measured. Data were statistically compared within and between LSTV subtypes and the normal variants. Results: LSTVs presented a wide range of morphometric differences in comparison to the normal bones. Grouping LSTV according to auricular surface positions (high, normal, and low) demonstrated significant between-group differences in the obliquity and thickness at the S1 and S2 segmental corridors. Conclusion: Frequent occurrence of LSTV in the general population may require evaluation of anatomical parameters in these variations for safe sacroiliac instrumentation around this region.

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Section: ) Sacralizationmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

Mahato

2020

Neurospine

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“…However, free-hand techniques have drawbacks. Postacchini et al 11 described that the joint space width of the sacroiliac joint varied with each patient because of constitutional characteristics and degenerative changes. Previous studies did not report controversy concerning an anatomical landmark of the entry point of the screw.…”

Section: Discussionmentioning

confidence: 99%

Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

Tatara

Niimura

Sekiya

et al. 2020

Global Spine Journal

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Study Design: A novel technique for S2-alar-iliac (S2AI) screw placement was analyzed. Objectives: Accurate confirmation of the S2AI screw trajectory with free-hand techniques is not simple, although some anatomical landmarks have been reported. To overcome the drawback, we aimed to introduce our technique for S2AI screw placement assisted with a guidewire using a new anatomical landmark. Methods: A total of 104 S2AI screws of 52 patients who underwent S2AI screw placement were investigated. Navigation software was used to simulate S2AI screw placement preoperatively. Screw placement was performed with the nonfluoroscopic free-hand technique. In this technique, a guidewire is inserted into the ilium from the extra-articular portion of the sacroiliac joint just lateral to the ideal screw entry point toward the tip of the greater trochanter and guides the screw trajectory. If the direction of the guidewire is satisfactory, all procedures of screw insertion are performed accordingly. The screw accuracy was assessed with computed tomography. Results: The modal size of the screw was 9.5 mm × 90 mm. The average horizontal angle was 42.0° (SD = 5.1°) on the right and 40.7° (SD = 4.7°) on the left. Of the 104 screws, 4 screws (3.9%) breached dorsally. No screw-related complication was observed. Conclusions: Because the guidewire can be inserted at an angle according to the individual morphology of the sacroiliac joint, it will be a reliable guide for the screw trajectory. This technique with a guidewire would help improve the accuracy of S2AI screw placement.

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“…Beginning from the age of puberty, the fusion takes place on the inferior part and continues to the superior one, leaving no residual intervertebral sacral disks during the first years of the fourth decade of human life (7). In the most common and typical anatomy of the bone, four articulations are included: two sacroiliac joints, the lumbosacral joint and the sacrococcygeal symphysis, while four pairs of sacral foramina are formed on both anterior and posterior surface of the bone (1,3,8).…”

Section: Introductionmentioning

confidence: 99%

Concurrent lumbosacral and sacrococcygeal fusion: a rare aetiology of low back pain and coccygodynia?

et al. 2018

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Morphometric anatomical and CT study of the human adult sacroiliac region

Cited by 19 publications

References 30 publications

Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

Re-examining the Spectrum of Lumbosacral Transitional Dysmorphisms: Quantifying Joint Asymmetries and Evaluating the Anatomy of Screw Fixation Corridors

Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

Concurrent lumbosacral and sacrococcygeal fusion: a rare aetiology of low back pain and coccygodynia?

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