Impact of Rigid Fixation of the Pubic Symphysis for Spinopelvic Fixation in Two Cases of Lumbosacral Agenesis

Spine Surgery and Related Research
Shunsuke KanbaraNoriaki Kawakami

Abstract

In patients with lumbosacral agenesis (SA), Renshaw type III or IV, lumbosacral instability is the primary cause of major clinical complications. Although they are usually treated with spinopelvic fusion, nonunion at the spinopelvic junction is a major complication due to the congenital sacropelvic abnormalities. The purpose of this study was to evaluate whether a combination of lumbosacral fixation and rigid fixation at the pubic symphysis could lead to postoperative bone union in patients with SA (Renshaw type III). Retrospective case series study. We present the cases of two patients with SA, Renshaw type III, who were surgically treated by lumbosacral fusion using a posterior approach, and they exhibited nonunion at the lumbosacral junction. Case 1. A 10-year-old male underwent T8-S posterior fixation followed by multiple augmentations using allografts at the lumbosacral junction for delayed union. All additional procedures with bone graft using a posterior approach failed to achieve bone union; however, additional rigid fixation at the pubic symphysis resulted in a successful lumbosacral bone union. Case 2. A 6-year-old male underwent vertical expandable prosthetic titanium rib (VEPTR) surgery with multiple rod extension p...Continue Reading

References

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BETA
amputation
X-ray

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VEPTR

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