Ventral abdominal approach for screw fixation of sacroiliac luxation in cadavers of cats and dogs

Luc R. Borer Department of Small Animal Surgery, Vetsuisse Faculty-Zurich, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

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Katja Voss Department of Small Animal Surgery, Vetsuisse Faculty-Zurich, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

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Pierre M. Montavon Department of Small Animal Surgery, Vetsuisse Faculty-Zurich, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

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Abstract

Objective—To investigate a technique for repair of sacroiliac luxation with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach.

Sample Population—Hemipelvis specimens from cadavers of 5 small- to large-breed dogs and 9 European shorthair cats.

Procedures—An optimal entry point and a safe drill corridor for implant placement were determined (4 hemipelvis specimens). Anatomic landmarks were identified, and the surgical technique for a ventral abdominal approach was described. Single positional screw placement was performed across the sacroiliac joint in 23 hemipelvis specimens. Screws were aimed at 25°(n = 2), 35° (2), and 45° (19) angles to the vertical axis in a transverse plane (α angles) and at a 90° angle to the longitudinal axis in a dorsal plane (β angle). Implant placement was assessed by radiographic evaluation of the cadavers and of the hemipelvis specimens devoid of soft tissue.

Results—By use of α angles of 35° and 45°, 20 of 21 implants were placed adequately; screws crossed the sacroiliac joint and penetrated the wing of the ilium without damaging adjacent nerves. The measured median α angle was 38°, and the median β angle was 88°. One complication was recorded.

Conclusions and Clinical Relevance—Cortical positional screw placement from the ventral aspect of the sacral wing by use of a ventral abdominal approach could be an alternative to conventional techniques. This novel technique may be useful for repair of bilateral sacroiliac luxation, treatment of concomitant soft tissue injuries of the caudal portion of the abdominal cavity or abdominal wall, and repair of pelvic floor fractures in a single approach.

Abstract

Objective—To investigate a technique for repair of sacroiliac luxation with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach.

Sample Population—Hemipelvis specimens from cadavers of 5 small- to large-breed dogs and 9 European shorthair cats.

Procedures—An optimal entry point and a safe drill corridor for implant placement were determined (4 hemipelvis specimens). Anatomic landmarks were identified, and the surgical technique for a ventral abdominal approach was described. Single positional screw placement was performed across the sacroiliac joint in 23 hemipelvis specimens. Screws were aimed at 25°(n = 2), 35° (2), and 45° (19) angles to the vertical axis in a transverse plane (α angles) and at a 90° angle to the longitudinal axis in a dorsal plane (β angle). Implant placement was assessed by radiographic evaluation of the cadavers and of the hemipelvis specimens devoid of soft tissue.

Results—By use of α angles of 35° and 45°, 20 of 21 implants were placed adequately; screws crossed the sacroiliac joint and penetrated the wing of the ilium without damaging adjacent nerves. The measured median α angle was 38°, and the median β angle was 88°. One complication was recorded.

Conclusions and Clinical Relevance—Cortical positional screw placement from the ventral aspect of the sacral wing by use of a ventral abdominal approach could be an alternative to conventional techniques. This novel technique may be useful for repair of bilateral sacroiliac luxation, treatment of concomitant soft tissue injuries of the caudal portion of the abdominal cavity or abdominal wall, and repair of pelvic floor fractures in a single approach.

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