Purpose

The purpose of this study is to evaluate preliminary outcomes of vertically unstable sacral fractures treated by lumbopelvic fixation (LPF) augmented transiliac bridged screws.

Methods

From April 2017 to December 2019, fifteen consecutive patients with vertically unstable sacral fractures who had undergone LPF augmented transiliac bridged screws were enrolled. The radiological assessment included standard lumbopelvic x-rays and pelvic computed tomography (CT) to evaluate the lumbosacral angle (LSA), sacral kyphosis angle (SKA), lumbar lordosis angles (LLA) and Matta’s reduction criterias (MRC). Clinical and neurologic impairment outcomes were evaluated by the Majeed grading scale (MGS) and Gibbons criterias, respectively.

Results

All patients were followed for an average of 18 months (range, 14–25). All sacral fractures eventually healed and implant failure did not occur in any patient, though there were two patients with a loss of reduction (< 5 mm) during the follow-up period. According to the MRC, the results were excellent on 14 sides, good on five sides, and fair on one side. The MGS mean score was 82 points (range, 49–98 points); the results were excellent in nine cases, good in four cases, and fair in two cases. There was no statistically significant difference in SKA and LLA in preoperative and postoperative final controls. The preoperative and postoperative LSA were 72 ± 13.9 and 44.1 ± 11.3, respectively, and a statistically significant improvement was observed (p = 0.01).

Conclusion

In vertically unstable sacrum fractures, we believe that LPF augmented with transiliac bridging technique may expedite the reduction of vertical sacrum fracture and offers a reinforced fixation choice.

中文翻译：

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使用桥式远端髂螺钉进行腰盆固定治疗垂直不稳定的骶骨骨折

目的

本研究的目的是评估腰盆固定（LPF）增强经髂桥螺钉治疗垂直不稳定骶骨骨折的初步结果。

方法

2017年4月至2019年12月，连续招募了15名接受LPF增强经髂桥螺钉治疗的垂直不稳定骶骨骨折患者。放射学评估包括标准腰盆腔 X 光检查和盆腔计算机断层扫描 (CT)，以评估腰骶角 (LSA)、骶骨后凸角 (SKA)、腰椎前凸角 (LLA) 和马塔复位标准 (MRC)。临床和神经损伤结果分别通过 Majeed 分级量表 (MGS) 和 Gibbons 标准进行评估。

结果

所有患者平均随访 18 个月（范围 14-25）。尽管有两名患者在随访期间出现复位丢失（< 5 mm），但所有骶骨骨折最终均愈合，并且没有发生任何患者植入失败的情况。根据 MRC 的结果，14 方面的成绩为优秀，5 方面为良好，1 方面为一般。MGS 平均分为 82 分（范围：49-98 分）；结果为优秀 9 例，良好 4 例，一般 2 例。术前和术后最终对照的SKA和LLA差异无统计学意义。术前和术后LSA分别为72±13.9和44.1±11.3，观察到统计学上显着的改善（p  =  0.01）。

结论

在垂直不稳定的骶骨骨折中，我们认为采用经髂桥技术增强 LPF 可能会加速垂直骶骨骨折的复位，并提供强化固定选择。