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- Title
Lumbopelvic fixation in the treatment of spinopelvic dissociation: union, complications, and neurologic outcomes of a multicenter case series.
- Authors
Moo Young, Justin P.; Savakus, Jonathan C.; Obey, Mitchel R.; Morris, Cade A.; Pereira, Daniel E.; Hills, Jeffrey M.; McKane, Ava; Babcock, Sharon N.; Miller, Anna N.; Mitchell, Phillip M.; Stephens, Byron F.
- Abstract
Purpose: To review outcomes of spinopelvic dissociation treated with open lumbopelvic fixation. Methods: We reviewed all cases of spinopelvic dissociation treated at three Level-I trauma centers with open lumbopelvic fixation, including those with adjunctive percutaneous fixation. We collected demographic data, associated injuries, pre- and postoperative neurologic status, pre- and postoperative kyphosis, and Roy-Camille classification. Outcomes included presence of union, reoperation rates, and complications involving hardware or wound. Results: From an initial cohort of 260 patients with spinopelvic dissociation, forty patients fulfilled inclusion criteria with a median follow-up of 351 days. Ten patients (25%) had a combination of percutaneous iliosacral and open lumbopelvic repair. Average pre- and postoperative kyphosis was 30 degrees and 26 degrees, respectively. Twenty patients (50%) had neurologic deficit preoperatively, and eight (20%) were unknown or unable to be assessed. All patients presenting with bowel or bladder dysfunction (n = 12) underwent laminectomy at time of surgery, with 3 patients (25%) having continued dysfunction at final follow-up. Surgical site infection occurred in four cases (10%) and wound complications in two (5%). All cases (100%) went on to union and five patients (13%) required hardware removal. Conclusion: Open lumbopelvic fixation resulted in a high union rate in the treatment of spinopelvic dissociation. Approximately 1 in 6 patients had a wound complication, the majority of which were surgical site infections. Bowel and bladder dysfunction at presentation were common with the majority of cases resolving by final follow-up when spinopelvic dissociation had been treated with decompression and stable fixation.
- Subjects
LUMBAR vertebrae surgery; SPINAL injuries; WOUNDS &; injuries; PELVIC bones; FRACTURE fixation; KYPHOSIS; TREATMENT effectiveness; LAMINECTOMY; MEDICAL device removal; SURGICAL complications; TRAUMA centers; SACRAL fractures; PELVIC fractures; REOPERATION; RESEARCH; LUMBAR vertebrae; SURGICAL site infections; EPIDEMIOLOGY
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2024, Vol 34, Issue 5, p2391
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-024-03928-4