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Asian Journal of Surgery Dec 2021
Topics: Bone Screws; Fluoroscopy; Fracture Fixation, Internal; Humans; Pelvic Bones; Robotics; Sacrum
PubMed: 34593280
DOI: 10.1016/j.asjsur.2021.08.008 -
International Journal of Obstetric... Feb 2015
Topics: Adult; Amides; Anesthesia, Epidural; Anesthesia, Obstetrical; Female; Fractures, Bone; Humans; Infant, Newborn; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications; Pubic Bone; Ropivacaine; Sacrum; Tomography, X-Ray Computed; Vacuum Extraction, Obstetrical
PubMed: 25499014
DOI: 10.1016/j.ijoa.2014.08.002 -
Techniques in Vascular and... Mar 2009Sacral vertebroplasty, or sacroplasty, entails the percutaneous insertion of 1 or more bone needles into the sacral ala and, less commonly, the sacral vertebra with... (Review)
Review
Sacral vertebroplasty, or sacroplasty, entails the percutaneous insertion of 1 or more bone needles into the sacral ala and, less commonly, the sacral vertebra with fluoroscopic and/or computed tomographic guidance. Acrylic bone cement is then injected under imaging guidance to treat the lesion and stabilize the sacrum. Sacroplasty is indicated for the treatment of painful sacral insufficiency fractures and painful sacral masses, both of which destabilize the sacrum. In properly selected patients, sacroplasty is an extremely efficacious procedure with a low-risk profile when performed with meticulous imaging guidance and a thorough appreciation of the complex sacral anatomy. Complete pain relief is observed in the overwhelming majority of patients that are treated for sacral insufficiency fractures. While the success rate is lower in patients with painful sacral neoplastic lesions, many of these patients experience a reduction in analgesic use and a return to ambulation.
Topics: Bone Cements; Humans; Radiography, Interventional; Sacrum; Spinal Fractures; Vertebroplasty
PubMed: 19769907
DOI: 10.1053/j.tvir.2009.06.006 -
JPMA. the Journal of the Pakistan... Jun 2007
Topics: Chordoma; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Radiography; Sacrococcygeal Region; Sacrum; Spinal Neoplasms; Surgical Procedures, Operative
PubMed: 17629241
DOI: No ID Found -
Skeletal Radiology Oct 1993We present the clinical and radiological features of two children with fatigue fractures of the sacrum. Both patients were active, had no underlying bone disease and... (Review)
Review
We present the clinical and radiological features of two children with fatigue fractures of the sacrum. Both patients were active, had no underlying bone disease and presented with insidious onset of low back pain. Plain radiography was non-contributory to the diagnosis. In both patients a focal area of increased activity was present in the lateral aspect of the sacrum on bone scintigraphy, which corresponded to linear medullary sclerosis in the sacral ala demonstrated by computed tomography. Magnetic resonance imaging in one patient revealed a linear signal void in the sacral ala on T1- and T2-weighted images. This was surrounded by diffuse low marrow signal on T1-weighted images, and increased marrow signal on T2-weighted images. Fatigue fractures of the sacrum should be considered in the differential diagnosis of low back pain in children. An awareness of their appearance on magnetic resonance imaging is important as this modality is increasingly utilised, particularly in children.
Topics: Adolescent; Child; Diagnostic Imaging; Female; Fractures, Stress; Humans; Magnetic Resonance Imaging; Male; Sacrum; Sclerosis; Spinal Fractures
PubMed: 8272888
DOI: 10.1007/BF00209099 -
Forensic Science International Sep 2012Sex determination in forensic practice is performed mostly on sexually dimorphic bones, including pelvic bones such as the os sacrum. Postmortem CT scan provides an easy...
Sex determination in forensic practice is performed mostly on sexually dimorphic bones, including pelvic bones such as the os sacrum. Postmortem CT scan provides an easy and fast method for depicting and measuring bone structures prior to elaborate autopsy preparations. To develop a simple and objective method for sex determination in postmortem CT, metric data were evaluated from CT images of the pelvic-associated os sacrum of 95 corpses (49 men and 46 women) from the Canton of Bern, Switzerland. Discriminant function analysis of the data showed that the best accuracy in determining sex was 76.8% and 78.9% with two different observers. It is concluded that measuring the os sacrumin postmortem CT for sex determination has moderate accuracy and should only be applied in combination with other methods.
Topics: Discriminant Analysis; Female; Forensic Anthropology; Humans; Male; Sacrum; Sex Determination by Skeleton; Tomography, X-Ray Computed
PubMed: 22521792
DOI: 10.1016/j.forsciint.2012.03.022 -
Critical Reviews in Computed Tomography 2002
Review
Topics: Female; Humans; Male; Osteomyelitis; Sacrum; Tomography, X-Ray Computed
PubMed: 11990651
DOI: No ID Found -
Injury Oct 2022U- and H-shaped fragility fractures of the sacrum (FFP IVb) are unstable fractures. Non-operative treatment may be associated with impaired walking abilities, chronic...
INTRODUCTION
U- and H-shaped fragility fractures of the sacrum (FFP IVb) are unstable fractures. Non-operative treatment may be associated with impaired walking abilities, chronic pain and the potential loss of independency. However, different treatment options are still controversially debated. The aim of surgical treatment includes sufficient fracture stability for immediate full weight bearing and good pain control postoperatively. A new surgical treatment algorithm was developed. This algorithm was evaluated in a cohort of geriatric patients with FFP type IVb regarding surgical complications and patient-related outcome.
METHODS
Retrospective case series. Patients ≥65 years, admitted with FFP IVb between 01/2017 and 12/2020 were included. Pelvic CT was performed and the surgical technique was chosen according to the proposed surgical treatment algorithm. For this algorithm, the technique of fracture stabilisation was adapted to sacral anatomy and the specific fracture pattern to minimize the impact of surgery and postoperative complications without compromising a sufficient fracture stability. Pain levels, complications and surgical revisions were recorded. Level of independency, walking abilities and -aids were compared 3- and 12- months postoperatively to the pre-injury situation.
RESULTS
Twenty-three patients were included. Outcome parameters could be obtained in 20 patients (85%) after three months and in 18 patients (78%) patients one year postoperatively. All patients were treated according to the algorithm. Sixteen patients received two transilio-transsacral screws (TI-TSS), whereas either lumbopelvic fixation (LPF) combined with a TI-TSS or bilateral ilio-sacral screws (ISS) was performed four times. Three patients underwent bilateral ISS into S1 with one TI-TSS into S2. Three days postoperatively, median pain VAS was 2 (0-8) compared to 7 (4-10) before surgery. One loosened TI-TSS was removed six weeks postoperatively. Three-month mortality was 14% (n=3). At one-year follow-up, all patients regained their pre-injury level of walking abilities.
CONCLUSIONS
Restoration of walking abilities, preservation of independency and efficient pain control can be achieved with surgical fixation of FFP type IVb fractures. With the proposed surgical algorithm, the fixation techniques are adapted to the fracture pattern to minimize the surgical burden.
LEVEL OF EVIDENCE
IV.
Topics: Aged; Algorithms; Bone Screws; Fracture Fixation, Internal; Fractures, Bone; Humans; Pain; Pelvic Bones; Retrospective Studies; Sacrum; Spinal Fractures
PubMed: 36028371
DOI: 10.1016/j.injury.2022.08.031 -
Medicina Clinica Dec 2015
Topics: Adult; Humans; Male; Ribs; Sacrum; Tomography, X-Ray Computed
PubMed: 26004279
DOI: 10.1016/j.medcli.2015.04.003 -
Spine Feb 2000A description of the internal architecture of the sacrum, including its trabecular arrangement, cortical thickness, and overall bone density.
STUDY DESIGN
A description of the internal architecture of the sacrum, including its trabecular arrangement, cortical thickness, and overall bone density.
OBJECTIVES
To determine the strong and weak areas in the sacrum to understand more clearly the sacral structure and its clinical implications.
METHODS
First, seven cadaveric sacral specimens were sectioned in different planes. Horizontal sections were performed at the upper S1, middle S1, S2, S3, and S4. Sagittal sections were made through the median sacral crest, the sacral foramina, and medial to the articular surface. A coronal section through the whole length of a sacral specimen was produced. All sections were studied radiographically, and the trabecular pattern was analyzed. In the second part of the study, axial computed tomography scans of 40 dry sacrum specimens were analyzed by using the National Institutes of Health Image 1.61 program. The cortical thickness and bone density were determined.
RESULTS
In the upper sacrum, three distinctive distributions of bony trabeculae were noted, one extending from the center of the sacral body anterolaterally, and the other two extending from the pedicle toward the auricular surface. A condensation zone was observed at the intersection of these trabeculae and was located at the anterior cortex of the foraminal zone. The junction between S2 and S3 represented a weak area with abrupt disappearance of the condensation zone. Analysis of the bone density of the sacrum using the plot analysis demonstrated that, at S1 and S2, the anterior cortex of the foraminal zone (condensation zone) is the most compact part of the sacrum.
CONCLUSION
These results suggest that the strongest part of the sacrum is the anterior cortex above the foramina in S1 and S2. The weakest point of the sacrum was found to lie at the level of the junction of S2 and S3.
Topics: Aged; Bone Density; Female; Humans; Male; Middle Aged; Sacrum; Tomography, X-Ray Computed
PubMed: 10703099
DOI: 10.1097/00007632-200002010-00006