A posterior approach for inspection of reduction of sacroiliac joint disruption.

This anatomic study was undertaken to describe a new posterior approach enabling direct inspection of reduction of sacroiliac joint disruption (SIJD), and guidance of iliosacral screw placement. The reduction of SIJD is usually monitored by inspection of the opposing sacrum and ilium at the posterior margin of the greater sciatic notch and there is a relative lack of information concerning inspection of reduction of SIJD from the posterosuperior aspect of the sacroiliac joint surface. Ten cadavers were dissected to determine the possibility of inspecting reduction of SIJD from the posterosuperior aspect of the sacroiliac joint by means of a posterior approach which passed immediately lateral to the deep back muscles and the fifth lumbar transverse process. The results indicated that the posterosuperior aspect of the sacroiliac joint surface and sacral ala can be directly palpated or visualised. This approach facilitates improved access for inspection of reduction of SIJD and guidance of iliosacral screw placement.