INTRODUCTION: The goal of the study was to evaluate both clinical and radiological outcome of a consecutive series of 11 patients submitted to lumboiliac fixation after lumbopelvic disjunction or associated injuries of the pelvis and lumbosacral tract in mid- and long-term follow-up. MATERIAL AND METHODS: The following were evaluated from clinical charts: damage control preoperative procedures, surgery, and pre-, intra- and post-operative complications; imaging was also evaluated from the preoperative assessment to the final follow-up (4 to 13.2 years; average 7.2 years). RESULTS: One patient died a few days after surgery; therefore, long-term follow-up was possible in 10 patients. One of the 10 patients could be evaluated only radiologically because he was non-compliant due to severe mental illness. There were four early complications: one patient had a massive pulmonary embolism, which was fatal; one had wound dehiscence; one developed pulmonary infection and one had caecal fistula, which was repaired by the general surgeon. Late complications were as follows: three patients required hardware removal or substitution because of deep infection (after 1year), system breakage (after 9 years) and screws loosening (after 7 years). Clinical evaluation was available in nine patients and was assessed using Oswestry forms and a Visual Analogue Scale (VAS). All patients were able to walk at least 1 kilometre without external support, two patients were using pain medication regularly and three patients were classified with severe disability at final follow-up. Degenerative changes in the joints close to the fused area were observed in two patients more than 10 years after the operation, but the correlation with surgery is questionable. DISCUSSION: Lumbopelvic disjunctions generally follow high-energy trauma often involving internal thoracic and abdominal organs; therefore, a well-trained team approach is mandatory to preserve patient life and to provide adequate treatment of skeletal injuries. Mechanical complications may occur several years after surgery, thus a long-term follow-up is mandatory. CONCLUSIONS: Lumbopelvic fixation is an effective surgical technique for treatment of spinopelvic disjunction. The patient numbers in this series, and in the literature in general, are low; therefore, a multicentre study is advisable to give evidence and statistical importance to our findings.
INTRODUCTION: The goal of the study was to evaluate both clinical and radiological outcome of a consecutive series of 11 patients submitted to lumboiliac fixation after lumbopelvic disjunction or associated injuries of the pelvis and lumbosacral tract in mid- and long-term follow-up. MATERIAL AND METHODS: The following were evaluated from clinical charts: damage control preoperative procedures, surgery, and pre-, intra- and post-operative complications; imaging was also evaluated from the preoperative assessment to the final follow-up (4 to 13.2 years; average 7.2 years). RESULTS: One patient died a few days after surgery; therefore, long-term follow-up was possible in 10 patients. One of the 10 patients could be evaluated only radiologically because he was non-compliant due to severe mental illness. There were four early complications: one patient had a massive pulmonary embolism, which was fatal; one had wound dehiscence; one developed pulmonary infection and one had caecal fistula, which was repaired by the general surgeon. Late complications were as follows: three patients required hardware removal or substitution because of deep infection (after 1year), system breakage (after 9 years) and screws loosening (after 7 years). Clinical evaluation was available in nine patients and was assessed using Oswestry forms and a Visual Analogue Scale (VAS). All patients were able to walk at least 1 kilometre without external support, two patients were using pain medication regularly and three patients were classified with severe disability at final follow-up. Degenerative changes in the joints close to the fused area were observed in two patients more than 10 years after the operation, but the correlation with surgery is questionable. DISCUSSION: Lumbopelvic disjunctions generally follow high-energy trauma often involving internal thoracic and abdominal organs; therefore, a well-trained team approach is mandatory to preserve patient life and to provide adequate treatment of skeletal injuries. Mechanical complications may occur several years after surgery, thus a long-term follow-up is mandatory. CONCLUSIONS: Lumbopelvic fixation is an effective surgical technique for treatment of spinopelvic disjunction. The patient numbers in this series, and in the literature in general, are low; therefore, a multicentre study is advisable to give evidence and statistical importance to our findings.
Authors: Emre Yilmaz; Martin F Hoffmann; Alexander von Glinski; Christiane Kruppa; Uwe Hamsen; Cameron K Schmidt; Ahmet Oernek; Matthias Koenigshausen; Marcel Dudda; Thomas A Schildhauer Journal: Sci Rep Date: 2020-09-10 Impact factor: 4.379