Sacral Vertebra

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Kadir Ertem - One of the best experts on this subject based on the ideXlab platform.

  • Isolated zone III vertical fracture of first Sacral Vertebra--a case report.
    Acta Orthopaedica, 2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    Copyright © Taylor & Francis 2005. ISSN 1745–3674. Printed in Sweden – all rights reserved. DOI 10.1080/17453670510041376 A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a central fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the vertical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junction (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight opening in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an additional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient was pain-free, with normal hip motion. Figure 1. A vertical fracture line on the S1 Vertebra could easily be seen on plain film.

  • Case report Isolated zone III vertical fracture of first Sacral Vertebra—a case report
    2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a cen-tral fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the ver-tical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junc-tion (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight open-ing in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an addi-tional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient

  • case report isolated zone iii vertical fracture of first Sacral Vertebra a case report
    2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a cen-tral fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the ver-tical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junc-tion (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight open-ing in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an addi-tional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient

Kellner, Alexander Wilhelm Armin - One of the best experts on this subject based on the ideXlab platform.

Andres Betts - One of the best experts on this subject based on the ideXlab platform.

  • Vertebroplasty of the First Sacral Vertebra
    Pain Physician, 2009
    Co-Authors: Andres Betts
    Abstract:

    The treatment of Sacral insufficiency fractures remains an area of active investigation and development, which has typically concentrated on the lateral elements of the sacrum and the Sacral ala. Although these fractures frequently involve the first Sacral (S1) Vertebral body, this structure has eluded a successful technique to accurately access its central portion for percutaneous cannula placement and cement delivery. In this article, we describe a percutaneous cannula placement technique developed in cadaver models, utilizing fluoroscopic imaging to enter the S1 Vertebral body using a transpedicular approach. The pedicle provides an anatomically safe entry point, but limits the cannula trajectory to the lateral aspect of the S1 Vertebral body, which makes delivery of poly(methyl methacrylate) (PMMA) cement to the central body of S1 difficult and unreliable by cannula placement alone. To access the central body of S1 we describe the application of the AVAflex curved nitinol needle, which can be readily directed though the cannula, previously placed through the S1 pedicle, into the central body of S1. The PMMA cement is delivered through the AVAflex needle under fluoroscopic monitoring and results in controlled deposition and good distribution within the central body of S1. The technique employs an extreme caudad angulation of the fluoroscope image intensifier that provides excellent visualization of the Sacral spinal canal similar to that obtained with an axial view under CT scan. This view allows for improving transpedicular cannula placement at S1, and real-time fluoroscopic monitoring of the cement deposition to quickly detect and avert possible extravasation toward the central spinal canal. This technique can be used with CT guidance for cannula placement combined with fluoroscopy for cement deposition or done entirely under fluoroscopy alone. Sacroplasty of the lateral Sacral element and Sacral ala may also be performed at the same time as the S1 vertebroplasty. It appears that with this curved nitinol needle technique, Sacral insufficiency fractures that involve the S1 Vertebral body may now be safely and accurately addressed. Conclusion: The treatment of Sacral insufficiency fractures by sacroplasty remains an evolving field. The technique using the curved AVAflex nitinol needle is another way to address the S1 component. Key Words: Vertebroplasty, sacroplasty, kyphoplasty, Vertebral augmentation, Sacral insufficiency fractures, osteoporosis

  • Vertebroplasty of the first Sacral Vertebra.
    Pain physician, 2009
    Co-Authors: Andres Betts
    Abstract:

    UNLABELLED The treatment of Sacral insufficiency fractures remains an area of active investigation and development, which has typically concentrated on the lateral elements of the sacrum and the Sacral ala. Although these fractures frequently involve the first Sacral (S1) Vertebral body, this structure has eluded a successful technique to accurately access its central portion for percutaneous cannula placement and cement delivery. In this article, we describe a percutaneous cannula placement technique developed in cadaver models, utilizing fluoroscopic imaging to enter the S1 Vertebral body using a transpedicular approach. The pedicle provides an anatomically safe entry point, but limits the cannula trajectory to the lateral aspect of the S1 Vertebral body, which makes delivery of poly(methyl methacrylate) (PMMA) cement to the central body of S1 difficult and unreliable by cannula placement alone. To access the central body of S1 we describe the application of the AVAflex curved nitinol needle, which can be readily directed though the cannula, previously placed through the S1 pedicle, into the central body of S1. The PMMA cement is delivered through the AVAflex needle under fluoroscopic monitoring and results in controlled deposition and good distribution within the central body of S1. The technique employs an extreme caudad angulation of the fluoroscope image intensifier that provides excellent visualization of the Sacral spinal canal similar to that obtained with an axial view under CT scan. This view allows for improving transpedicular cannula placement at S1, and real-time fluoroscopic monitoring of the cement deposition to quickly detect and avert possible extravasation toward the central spinal canal. This technique can be used with CT guidance for cannula placement combined with fluoroscopy for cement deposition or done entirely under fluoroscopy alone. Sacroplasty of the lateral Sacral element and Sacral ala may also be performed at the same time as the S1 vertebroplasty. It appears that with this curved nitinol needle technique, Sacral insufficiency fractures that involve the S1 Vertebral body may now be safely and accurately addressed. CONCLUSION The treatment of Sacral insufficiency fractures by sacroplasty remains an evolving field. The technique using the curved AVAflex nitinol needle is another way to address the S1 component.

Ahmet Harma - One of the best experts on this subject based on the ideXlab platform.

  • Isolated zone III vertical fracture of first Sacral Vertebra--a case report.
    Acta Orthopaedica, 2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    Copyright © Taylor & Francis 2005. ISSN 1745–3674. Printed in Sweden – all rights reserved. DOI 10.1080/17453670510041376 A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a central fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the vertical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junction (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight opening in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an additional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient was pain-free, with normal hip motion. Figure 1. A vertical fracture line on the S1 Vertebra could easily be seen on plain film.

  • Case report Isolated zone III vertical fracture of first Sacral Vertebra—a case report
    2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a cen-tral fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the ver-tical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junc-tion (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight open-ing in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an addi-tional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient

  • case report isolated zone iii vertical fracture of first Sacral Vertebra a case report
    2005
    Co-Authors: Ahmet Harma, Muharrem Inan, Kadir Ertem
    Abstract:

    A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a cen-tral fracture of the first Sacral Vertebra and pubic symphysis diastasis of 30 mm with bilateral pubic rami fractures (Figure 1). CT revealed that the ver-tical midline fracture was limited to the first Sacral Vertebra. Bilateral Sacral compression fractures were also present at the level of the S2–S3 junc-tion (Figure 2). The patient was operated for pubic diastasis 48 hours later and symphyseal closure was maintained by a 5-hole reconstruction plate. The bilateral ramii fractures and the slight open-ing in the right sacroiliac joint were managed with a pelvic anterior external fixator. It was suggested that by anterior external fixation, a stable fixation in such a slight posterior sacroiliac opening could be maintained and it could be more beneficial for the ramii fractures rather than a wide exploration on both sides. Because the lesion was vertically stable, and because anterior instability was more severe than posterior unilateral opening, an addi-tional posterior fixation was not considered. The external fixator was removed after 2 months. Full weight bearing was allowed after 3 months. At 9 months, the fractures were healed and the patient

Bittencourt, Jonathas De Souza - One of the best experts on this subject based on the ideXlab platform.

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