Single Incision Posteromedial to Ventrolateral (PML) Surgical Technique for Minimally Invasive Sacroiliac Joint Fusion.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI:10.1097/BSD.0000000000001867

Babajide Ogunseinde

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引用次数: 0

Abstract

Summary of background data: Sacroiliac joint fusion transfixing procedures place implants across 3 bone cortices. The most studied trajectory is lateral to medial. While the safety and effectiveness of this trajectory have been well documented, concerns of vascular injury involving the branches of the SGA over the lateral ilium have been raised. In heavier patients, a straight lateral-to-medial trajectory frequently requires traversing through a significant amount of soft tissue. While the posterolateral transfixing trajectory decreases the amount of soft tissue dissection, concerns of inferior patient outcomes and biomechanical stability have been published. Herein, we describe a new transfixing procedure for SIJ fusion with implants starting on the dorsal sacrum with a posteromedial to ventrolateral (sacro-alar iliac) implant trajectory.

Methods: A case video of posteriomedial to ventrolateral SIJ fusion demonstrates the operative technique and is accompanied by a step-by-step description of this technique. Four cases are presented.

Conclusions: The posteromedial to ventrolateral operative trajectory allows for minimally invasive bilateral SIJ fusion through a single incision with minimal tissue disruption and avoids branches of the superior gluteal artery.

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微创骶髂关节融合术的单切口后内侧至腹外侧（PML）手术技术。

背景资料总结：骶髂关节融合穿刺术将植入物放置在3个骨皮质上。研究最多的轨迹是从外侧到内侧。虽然这种方法的安全性和有效性已经得到了充分的证明，但对髂外侧SGA分支的血管损伤的担忧已经提出。在体重较重的患者中，从外侧到内侧的直线轨迹经常需要穿过大量的软组织。虽然后外侧穿刺轨迹减少了软组织剥离的数量，但对患者预后和生物力学稳定性较差的担忧已经发表。在此，我们描述了一种新的SIJ融合固定手术，从骶骨背侧开始，采用后内侧到腹外侧（骶翼髂）植入轨迹。方法：一段后内侧到腹外侧SIJ融合的病例视频演示了手术技术，并附有该技术的一步一步的描述。提出了四个案例。结论：后内侧至腹外侧的手术轨迹允许通过单个切口进行微创双侧SIJ融合，使组织破坏最小，避免了臀上动脉分支。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.