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Anatomic relationship between S2 sacroiliac screws’ entry points and pelvic external branches of superior gluteal artery

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Objective

To study the relationship between the pelvic external branches of the superior gluteal artery and the entry area of the S2 sacroiliac screw to provide the anatomical basis and technical reference for avoiding the superior gluteal artery injury during the clinical screw placement.

Methods

CTA imaging of superior gluteal artery of 74 healthy adults (37 males and 37 females) was randomly selected. The safe bony entry area (‘safe area’ for abbreviation) of S2 sacroiliac screw in the standard lateral view of the pelvis three-dimensional reconstruction CT image was determined by the CT auxiliary measurement software. The relationship between the pelvic external branches of the superior gluteal artery and the safe area of S2 sacroiliac screw was observed, and the cases in which the artery intersected the safe area were counted. The distance between the safe area and the superior gluteal artery branches closest to it was measured for the cases in which the artery and the safe area did not intersect.

Results

21 of the 74 cases did not have a bone channel of horizontal S2 sacroiliac screw, so they were excluded from this study. In the remaining 53 cases, 12 cases had the deep superior branch of the superior gluteal artery through the safe area of S2 screw (22.6%), and 16 cases had the superficial branch of the superior gluteal artery through the safe area of S2 screw (30.2%). There was no obvious overlap feature and law between the safe area and the superficial and deep superior branches. In 20 cases of the 53 cases, the safe area of S2 screw was located between the deep superior branch and the superficial branch of superior gluteal artery (37.7%), and in 5 cases, the safe area of S2 screw was located behind the superficial branch of superior gluteal artery (9.4%). In the cases where the superior gluteal artery did not intersect the screw entry bony safe area, the part of superior gluteal artery closest to the safe area was located in front or back of the widest part of the safe area.

Conclusion

The risk of accidental injury of the deep superior branch and superficial branch of the superior gluteal artery is high during the process of S2 sacroiliac screw placement. Even if the screw entry point is located in the bony safe area, the absolute safety of screw placement cannot be guaranteed. We strongly suggest that a careful and thorough plan is needed before surgery.

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Funding

This research was supported by the National Natural Science Foundation of China (no. 81301553 and no. 81641171), Distinguished Middle-Aged and Young Scientist Encourage and Reward Foundation of Shandong Province, China (no. BS2013SF015), Shandong Provincial Key R&D Program of China (no. 2018GSF118064), Project of Medical and Health Technology Development Program of Shandong Province, China (no. 2017WS169), Project of Traditional Chinese Medicine Science and Technology Development Program of Shandong Province, China (no. 2017-391) and Project of Science and Technology Development Program of Yantai City, China (no. 2010149-10, no. 2013WS234, and no. 2016WS036).

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Authors and Affiliations

  1. Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264008, People’s Republic of China

    Yong Zhao, Wenliang Li, Jingning Li, Dexin Zou, Xiujiang Sun, Gong Cheng, Shengjie Dong & Tao Sun

  2. CT/MR Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264008, People’s Republic of China

    Wei Lian

Authors
  1. Yong Zhao
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  2. Wenliang Li
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  3. Wei Lian
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  4. Jingning Li
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  5. Dexin Zou
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  6. Xiujiang Sun
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  7. Gong Cheng
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  8. Shengjie Dong
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  9. Tao Sun
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Corresponding author

Correspondence to Yong Zhao.

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Conflict of interest

Yong Zhao, Wenliang Li, Wei Lian, Jingning Li, Dexin Zou, Xiujiang Sun, Gong Cheng, Shengjie Dong and Tao Sun declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committees of Yantai Shan Hospital.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Zhao, Y., Li, W., Lian, W. et al. Anatomic relationship between S2 sacroiliac screws’ entry points and pelvic external branches of superior gluteal artery. Eur J Trauma Emerg Surg 48, 857–862 (2022). https://doi.org/10.1007/s00068-021-01622-2

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  • DOI: https://doi.org/10.1007/s00068-021-01622-2

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