SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE
ABSTRACT Spinopelvic instability is an uncommon injury that is caused by high-energy traumas. Surgical treatment is used, in the majority of cases, to restore stability and enable early mobilization. Various stabilization techniques have been used in the treatment of spinopelvic instability, and lum...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Coluna (SBC)
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| Series: | Coluna/Columna |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000100069&lng=en&tlng=en |
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| author | VINÍCIUS MAGNO DA ROCHA JOÃO ANTONIO MATHEUS GUIMARÃES ANTÔNIO PAULO DE OLIVAES FILHO FELIPE MOURA CARRASCO ANTÔNIO EULALIO PEDROSA ARAUJO JUNIOR DIEGO PINHEIRO AGUIAR ANDRÉ LUIZ LOYELO BARCELLOS |
| author_facet | VINÍCIUS MAGNO DA ROCHA JOÃO ANTONIO MATHEUS GUIMARÃES ANTÔNIO PAULO DE OLIVAES FILHO FELIPE MOURA CARRASCO ANTÔNIO EULALIO PEDROSA ARAUJO JUNIOR DIEGO PINHEIRO AGUIAR ANDRÉ LUIZ LOYELO BARCELLOS |
| author_sort | VINÍCIUS MAGNO DA ROCHA |
| collection | DOAJ |
| description | ABSTRACT Spinopelvic instability is an uncommon injury that is caused by high-energy traumas. Surgical treatment is used, in the majority of cases, to restore stability and enable early mobilization. Various stabilization techniques have been used in the treatment of spinopelvic instability, and lumbopelvic fixation (LPF) is currently the technique of choice due to its biomechanical superiority. One of its limitations is the fact that the technique does not directly address the lower sacral segment, permitting a residual kyphotic deformity. This deformity has been attributed to unsatisfactory outcomes, including late development of pelvic floor muscle defects and complications during childbirth. We report a case of a patient with spinopelvic instability due to sacral fracture, which was treated using a variation of the LPF technique, in which rods and screws originally developed for cervicothoracic fixation were adapted to correct sacral deformity in the sagittal plane. The upper sacral segment was reduced indirectly using hip extension and femoral traction manoeuvres, associated with distraction manoeuvres via rods. Bone reduction forceps were used to reduce the kyphotic deviation in the lower sacral fragment, enabling its fixation to the lumbopelvic rod and screws system. There were no complications of infection, suture dehiscence, or breakage of the implants, and at the end of the first year of follow-up, the sacral kyphosis was normal and radiographic consolidation was confirmed. Our technique provides a viable and promising alternative to traditional LPF, making it especially useful in fractures with accentuated deviations of the lower sacral fragment. Level of Evidence: 4.Type of study: Case series |
| first_indexed | 2024-12-17T00:15:00Z |
| format | Article |
| id | doaj.art-cd31b58a632141b8bccc2d61db0aa103 |
| institution | Directory Open Access Journal |
| issn | 2177-014X |
| language | English |
| last_indexed | 2024-12-17T00:15:00Z |
| publisher | Sociedade Brasileira de Coluna (SBC) |
| record_format | Article |
| series | Coluna/Columna |
| spelling | doaj.art-cd31b58a632141b8bccc2d61db0aa1032022-12-21T22:10:44ZengSociedade Brasileira de Coluna (SBC)Coluna/Columna2177-014X171697310.1590/s1808-185120181701174141S1808-18512018000100069SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUEVINÍCIUS MAGNO DA ROCHAJOÃO ANTONIO MATHEUS GUIMARÃESANTÔNIO PAULO DE OLIVAES FILHOFELIPE MOURA CARRASCOANTÔNIO EULALIO PEDROSA ARAUJO JUNIORDIEGO PINHEIRO AGUIARANDRÉ LUIZ LOYELO BARCELLOSABSTRACT Spinopelvic instability is an uncommon injury that is caused by high-energy traumas. Surgical treatment is used, in the majority of cases, to restore stability and enable early mobilization. Various stabilization techniques have been used in the treatment of spinopelvic instability, and lumbopelvic fixation (LPF) is currently the technique of choice due to its biomechanical superiority. One of its limitations is the fact that the technique does not directly address the lower sacral segment, permitting a residual kyphotic deformity. This deformity has been attributed to unsatisfactory outcomes, including late development of pelvic floor muscle defects and complications during childbirth. We report a case of a patient with spinopelvic instability due to sacral fracture, which was treated using a variation of the LPF technique, in which rods and screws originally developed for cervicothoracic fixation were adapted to correct sacral deformity in the sagittal plane. The upper sacral segment was reduced indirectly using hip extension and femoral traction manoeuvres, associated with distraction manoeuvres via rods. Bone reduction forceps were used to reduce the kyphotic deviation in the lower sacral fragment, enabling its fixation to the lumbopelvic rod and screws system. There were no complications of infection, suture dehiscence, or breakage of the implants, and at the end of the first year of follow-up, the sacral kyphosis was normal and radiographic consolidation was confirmed. Our technique provides a viable and promising alternative to traditional LPF, making it especially useful in fractures with accentuated deviations of the lower sacral fragment. Level of Evidence: 4.Type of study: Case serieshttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000100069&lng=en&tlng=enSacroFerimentos e lesõesCifose |
| spellingShingle | VINÍCIUS MAGNO DA ROCHA JOÃO ANTONIO MATHEUS GUIMARÃES ANTÔNIO PAULO DE OLIVAES FILHO FELIPE MOURA CARRASCO ANTÔNIO EULALIO PEDROSA ARAUJO JUNIOR DIEGO PINHEIRO AGUIAR ANDRÉ LUIZ LOYELO BARCELLOS SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE Coluna/Columna Sacro Ferimentos e lesões Cifose |
| title | SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE |
| title_full | SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE |
| title_fullStr | SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE |
| title_full_unstemmed | SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE |
| title_short | SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE |
| title_sort | sacral fracture treatment with a variation of the lumbopelvic fixation technique |
| topic | Sacro Ferimentos e lesões Cifose |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000100069&lng=en&tlng=en |
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