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1.
OBJECTIVE: To investigate sacroiliac luxation repair with positional screw insertion from the ventral surface of the sacral wing via a ventral abdominal approach in cats. ANIMALS: 18 European shorthair cats. PROCEDURES: All cats underwent clinical examination including orthopedic and neurologic examination and assessment of lameness and pain before and immediately after surgery and 6 and 16 weeks after surgery. All sacroiliac luxations were stabilized with a single positional 2.4-mm cortical titanium self-tapping screw. The pelvic floor was also repaired in selected cats. Screw entry points and angles determined in a prior study of cadavers were used. Radiographs were taken before surgery and during follow-up evaluations to assess postoperative sacroiliac luxation reduction, implant placement, and repair stability. RESULTS: All implants were placed correctly. Iatrogenic sciatic nerve injuries occurred in 2 cats. Median time to ambulation was 1.5 days for cats with sacroiliac luxation as the sole injury. Radiographic outcome of sacroiliac luxation repair was excellent in 15 of 17 repairs, good in 1 of 17 repairs, and poor in 1 of 17 repairs. Clinical outcome was excellent in 11 of 15 cats and good in 4 of 15 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Insertion of a positional screw across the sacroiliac joint via a ventral abdominal approached can be an alternative to conventional techniques of sacroiliac luxation repair in cats. This novel technique allowed repair of bilateral sacroiliac luxation, repair of pelvic floor fractures, and treatment of soft tissue injuries of the abdominal cavity or abdominal organs with a single approach.  相似文献   

2.
One hundred canine sacral bone specimens were examined to identify surgical landmarks that may improve screw placement in sacroiliac repair. A lateral view of the sacral wing was studied, as this structure is most easily identified in the dorsal approach used for sacroiliac repair. The height and length of each sacral wing were measured. Four other features of the canine sacrum were identified and measured in comparison with the sacral wing height and length. The cranial overlap of the sacral wing over the intervertebral space of L7-S1 was found to have a mean of 14% of the length of the sacral wing. The ventral overlap of the sacral wing over the pelvic canal was found to be 21% of the height of the sacral wing. The ventral limit of the spinal canal (dorsal limit of the sacral body) was 45% of the sacral wing height. The first pelvic foramen was located at a mean distance of 64% of the sacral wing length and 20% of the sacral wing height. Using these four features, a composite view of the sacral wing is described to illustrate the area of the sacral body where screw placement is optimal.  相似文献   

3.
OBJECTIVE: To define a safe corridor in the dorsoventral plane to facilitate placement of screws inserted in lag fashion within the sacral body for fixation of sacroiliac fracture-luxation injuries in dogs. STUDY DESIGN: Anatomic study. SAMPLE POPULATION: Cadaveric canine sacra. METHODS: Canine sacra (n=45) were used for a radiographic study to define a safe corridor in the dorsoventral plane for placement of screws inserted in lag fashion for fixation of sacroiliac luxation in the dog. The defined safe corridor allowed drilling to a depth of 65% of the sacral width to ensure screw purchase of > or =60%. Effects of positioning and measurement techniques were evaluated. RESULTS: Eighty-seven safe corridors were measured. The mean articular surface was 100+/-4.52 degrees from horizontal. Mean maximum, optimum, and minimum safe corridor drill angles were 111+/- 4.57 degrees, 100+/-4.70 degrees, and 89+/-5.17 degrees, respectively, from the articular surface. Predicted surgeon error of +/-4 degrees was used to define the safe corridor for use clinically. CONCLUSIONS: In 91% of sacra, a drill angle of 100+/-4 degrees would remain ventral to the vertebral canal. Twelve sacra (14%) were at risk of penetration of the pelvic canal. A drill angle of 97+/-4 degrees avoids penetration of the vertebral canal in all sacra measured but risks ventral exit from the body in 30% of sacra studied. CLINICAL RELEVANCE: A drill angle of 97 degrees from the articular surface is recommended for insertion of screws for lag fixation of canine sacroiliac luxation.  相似文献   

4.
Frozen cadaver specimens from three dogs were used to create a sectional anatomic atlas of the sacroiliac region. Frozen/thawed cadaver specimens from 12 dogs were used to develop an ultrasound-guided sacroiliac joint injection technique. Accuracy of the technique was tested in 15 additional canine cadaver specimens, using injectate containing blue dye and iodinated contrast medium. Sonoanatomic landmarks for consistently identifying a caudodorsal window into the canine sacroiliac joint space included the L7-S1 articular process joints, ilial wing, sacral wing, sacral lamina, and median sacral crest. Accuracy of ultrasound-guided sacroiliac joint injection was not significantly affected by operator, but was affected by the tissue location targeted and the reference standard used for calculations. Accuracy of the technique was good for placing injectate into either the synchondrosis component, dorsal sacroiliac ligament or ventral sacroiliac ligament; fair to poor for placing injectate into the synovial component; and poor for placing injectate into all four sacroiliac soft tissue structures. Concurrent placement of injectate into extraarticular tissues occurred frequently. We conclude that ultrasound-guided sacroiliac joint injection is feasible for evaluation as a treatment method for lumbosacral region pain in dogs, but is not sufficiently accurate for localizing pain to the sacroiliac joint alone.  相似文献   

5.
Objective— To evaluate outcome by radiographic assessment after closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture‐luxations in dogs. Study Design— Retrospective study. Animals— Dogs (n=24) with sacroiliac fracture‐luxations. Methods— Medical records (1999–2006) and radiographs of 24 dogs (29 fracture‐luxations) that had stabilization of sacroiliac fracture‐luxation by fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion were reviewed. Signalment, body weight, number, and location of all concurrent injuries and implants used for repair were recorded. Radiographs were used to evaluate the accuracy of screw placement in the sacral body, screw depth/sacral width ratio, reduction of the sacroiliac joint, pelvic canal diameter, and hemipelvic canal width. Radiographic re‐examination (range, 4 to >8 weeks postoperatively) was available for evaluation. Results— Mean screw depth/sacral width ratio on immediate postoperative and re‐examination radiographs was 64% and 61%, respectively. Mean percentage reduction of the sacroiliac joint on immediate postoperative and re‐examination radiographs were 91% and 87%, respectively. Pelvic canal diameter ratio demonstrated successful restoration of the pelvic canal. Hemipelvic canal width ratio documented successful closed reduction repair independent of concurrent pelvic injuries. Conclusion— Successful repair of sacroiliac fracture‐luxations, determined by radiographic assessment, can be achieved by fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion. Clinical Relevance— Fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture‐luxations is a minimally invasive technique that restores and maintains pelvic canal dimensions and should be considered as an alternative to open reduction or nonsurgical management of sacroiliac fracture‐luxations.  相似文献   

6.
OBJECTIVE: To describe a technique for closed reduction and percutaneous insertion of a lag screw for fixation of sacroiliac fracture-luxations, and to report the success of this technique in stabilizing sacroiliac fracture-luxations. STUDY DESIGN: A retrospective clinical study. STUDY POPULATION: 13 consecutive client-owned dogs with sacroiliac fracture-luxations. METHODS: Sacroiliac fracture-luxations were stabilized by using a closed reduction and percutaneous lag screw fixation technique. Preoperative, postoperative, and last re-examination radiographs were used to assess the location and number of pelvic injuries, other orthopedic injuries, percent reduction of the sacroiliac joint, percent sacral width screw depth, position of the screw, pelvic canal diameter ratio, hemipelvic canal width ratio, and complications. Information on signalment, weight, weight-bearing status, neurologic status, and complications was obtained from the medical record. RESULTS: Mean percent reduction of the sacroiliac joint was 92.33%. All screws were placed within the sacral body with a mean screw depth/sacral width of 79.03%. No screw loosening occurred. Mean pelvic canal diameter ratios were 0.99, 1.20, and 1.14 preoperatively, immediately postoperatively, and at the last re-examination, respectively. Nine of 13 dogs were willing to walk on the ipsilateral rear leg the day after surgery. CONCLUSIONS: Closed reduction and percutaneous insertion of a lag screw for stabilization of fracture-luxation of the sacroiliac joint is an acceptable method of repair. CLINICAL RELEVANCE: Sacroiliac fracture-luxations can be successfully reduced and stabilized using a minimally invasive technique.  相似文献   

7.
Objective: To define a safe corridor in the dorsal plane relative to the articular surface for placement of a single screw in lag fashion to achieve stabilization of sacroiliac luxation in the dog. Study Design: Cadaveric study. Methods: Dorsoventral radiographs of denuded canine sacra (n=49) were taken to determine the safe corridor in the craniocaudal plane, and the maximum, optimum and minimum angles were calculated that would allow a screw inserted in lag fashion to engage at least 60% of the width of the sacral body without cranial or caudal penetration through the bone. Results: The mean safe corridor in the dorsal plane is ～24° wide. Mean craniocaudal minimum, optimum and maximum drill angles from the drill start point were 88°, 100°, and 111° from the articular surface, respectively. No single angle will completely avoid risk of screw penetration beyond the safe corridor cranially and caudally. Conclusions: There is sufficient anatomic variation between different canine sacra that a single angle cannot be recommended for screw placement in the dorsal plane. Clinical Relevance: A standard angle cannot be recommended for screw placement in lag fashion within the canine sacrum in the dorsal plane. Because of the narrow width of the safe corridor, preoperative measurements on radiographs are recommended and a range of angled drill guides may be useful to decrease surgeon margin of error.  相似文献   

8.
A ventrolateral approach to the sacroiliac joint is described as an alternative to the dorsolateral approach for the repair of sacroiliac dislocations and sacral wing fractures. The technique described here usually is performed blindly with digital palpation; however, the approach may be extended craniodorsally, allowing direct visualization of the sacroiliac joint. This technique facilitates reduction and stable fixation, with good purchase of the implants in the sacrum, for the repair of sacroiliac fracture-dislocation. This method of repair was used on 20 patients, with good to excellent clinical results.  相似文献   

9.
Objective— To define a safe corridor in the dorsoventral plane within the feline sacral body for placement of screws inserted in lag fashion for repair of sacroiliac luxation.
Study Design— Anatomic study.
Sample Population— Frozen cadaveric feline sacra.
Methods— Feline sacra (n=20) were used to perform a radiographic study to define a safe corridor to a depth of 66% of the sacral body width. Two drill start points (A and B) were evaluated. Dorsal exit from the safe corridor was considered unacceptable.
Results— Forty safe corridors were measured. The mean articular surface was 100±6.4° from horizontal. Mean maximum, optimum, and minimum safe corridor drill angles from drill point A were 107±6.8°, 97±6.9°, and 87±7.2°, respectively, from the articular surface. Mean maximum, optimum, and minimum angles from drill point B were 109±7.2°, 99±7.1°, and 89.5±7.2°, respectively. Point B increased the risk of ventral exit from the sacral body.
Conclusions— Point A and a drill angle of 90±4° for drilling of the feline sacral body is recommended. This margin for error risks ventral exit from the body in 23/40 (58%) of the sacra in this study. Reduction of the margin for error to ±2° would reduce the risk of ventral exit to 14/40 (35%) of the sacra in this study.
Clinical Relevance— Drilling at 90° to the feline sacral articular surface is recommended. Findings from this study present a strong case for use of angled drill guides.  相似文献   

10.
Objectives: To evaluate the acetabular ventroversion obtained with a modified triple pelvic osteotomy (2.5 PO) compared with that resulting from standard double pelvic osteo-tomy (DPO). Study design: Ex vivo study. Animals: Seven pelves obtained from skeletally mature dogs with a total body weight ranging from 26-41 kg were used. Methods: Unilateral DPO technique and dorsal ischial mono-cortical osteotomy were performed on every right hemipelvis. Angular ventral rotation was measured by determining the relative orientation of two Kirschner wires placed in the ilial wing and in the dorsal acetabular rim. Results: The mean angle of ventroversion was 9.5 ± 5.2 degrees for the DPO group (range 2.1-18.1) and 10.9 ± 4.8 degrees for the 2.5 PO group (range 4.1-19.5). The mean difference between the 2.5 PO and DPO was 1.5 ± 0.6 degrees (range 0.5-2.1). Conclusions: The 2.5 PO technique increased acetabular ventroversion versus DPO.  相似文献   

11.
Objective: To (1) identify prognostic indicators for stability after stabilization of sacroiliac luxation with screws inserted in lag fashion and (2) report dorsoventral dimensions of the sacrum in cats. Study Design: Multicenter retrospective study. Sample Population: Cats (n=40) with sacroiliac luxation. Methods: Case records and radiographs of cats presented at the Queen's Veterinary School Hospital Cambridge and the Royal Veterinary College Hatfield for screw fixation of sacroiliac luxation were reviewed. Dorsoventral dimensions of 15 feline cadaveric sacral bodies were measured to identify the appropriate implant size for use in fixation with screws inserted in lag fashion. Results: Of 40 cats, 13 had left, 14 right, and 13 bilateral sacroiliac luxations. Of 48 screws analyzed, 42 (87.5%) were placed within the sacral body or exited ventrally and 6 (12.5%) were considered malpositioned. Screw purchase within the sacrum was statistically different between unstable and stable repairs (P=.001). Using confidence intervals for screw length within the sacrum and effect on stability, the lowest screw depth that contained 95% of the screws that did not loosen was ∼60% of the sacral width. Mean dorsoventral sacral dimension at its narrowest point was 5.9±1.14 mm. There was no significant difference in the incidence of implant loosening between those luxations that were 100% reduced and those that were <100% reduced (P=.7837). Conclusions: Screw purchase within the feline sacrum of at least 60% of the sacral width significantly reduces the risk of loosening. Clinical Relevance: Screw placement to a depth of 60% of the width of the feline sacrum is recommended.  相似文献   

12.
Objective— To describe and evaluate a transiliac approach to the L7–S1 disk and intervertebral foramen in dogs.
Study Design— Cadaver study.
Animals— Fresh canine cadavers (n=10).
Methods— A craniolateral approach was made to each iliac wing of 10 fresh canine mixed breed cadavers. An 18 mm hole was drilled in a standardized position through the iliac wing. The musculature connected to the cranial aspects of the sacral wing was dissected and retracted cranially through this iliac window. Endoscopic exploration of the area was performed.
Results— The foramen and intervertebral disk were clearly observed in all specimens without iatrogenic injury of the L7 nerve branch. Access to the foramen was possible in 16 of 20 specimens without excision of the sacral wing; however, it was always partially excised to observe the intervertebral disk which lies more caudally and ventrally.
Conclusion— Transiliac approach to the lumbosacral joint allows direct exposure of the intervertebral disk and foramen through an iliac window. Endoscopic exploration provided good observation of the intervertebral disk and/or foramen.
Clinical Relevance— Transiliac approach could be used for lateral corpectomy and foraminotomy in dogs with degenerative lumbosacral stenosis caused by ventral or ventrolateral disk protrusion, foramen stenosis, or OCD of the L7–S1 joint. Clinical study will be necessary to evaluate the efficacy of this approach.  相似文献   

13.
OBJECTIVE: To define landmarks on the canine ilial wing for accurate, consistent insertion of implants into the 1st sacral (S1) vertebral body when the sacroiliac joint is intact. STUDY DESIGN: Anatomic study. ANIMALS: Intact, cadaveric canine pelves and sacra (n=25). METHODS: Median sections (5 specimens) were drilled from the center of S1 in a lateral direction, exiting on the ilial wing. Landmarks on the ilial wing and shaft used to define this exit point were then used to locate this point on both wings of 20 articulated specimens, positioned and rigidly held so that the dorsal plane of the pelvis was aligned with a plumb line and the median plane of the pelvis was horizontal. A 2 mm hole was drilled from the marked point, parallel to the plumb line, until it exited the contralateral ilial wing. Distance of drill hole position from the geometric center (GC) of S1 was located on median and paramedian plane images derived from plane, computed tomographic (CT) scans. RESULTS: The entire drill hole was located within S1 in 18 specimens. Mean deviation of the hole from GC (ratio of the distance of GC from the closest S1 body border) in median section was 0.40 +/- 0.29 (craniocaudal direction) and 0.29 +/- 0.23 (dorsoventral). CONCLUSIONS: Use of ilial wing landmarks and drilling perpendicular to the median plane will improve accuracy for insertion of implants into S1 when the sacroiliac joint is intact. CLINICAL RELEVANCE: Ilial wing landmarks should be used to improve accuracy of implant insertion into S1.  相似文献   

14.
The case records of 92 consecutive dogs that suffered sacroiliac fracture-separation were examined. Seventy-seven per cent (71 of 92) had unilateral sacroiliac injury and 23% (21 of 92) had bilateral sacroiliac injury. Of the unilateral cases, 93% (66 of 71) of the dogs had associated acetabular, ilial, femoral, or tibial fractures; coxofemoral luxations; or cruciate injuries. Eighty-five per cent (78 of 92) of the dogs had either bilateral sacroiliac injury or unilateral sacroiliac injury and other orthopedic injuries of the opposite limb, thus disabling both hind limbs.
Sixty-five per cent (60 of 92) of the dogs received lag screw fixation of the sacroiliac joint. Of 29 dogs that were re-radiographed on an average of 437 days following fixation, 38% (11 of 29) showed evidence of loosening of the lag screw fixation.a
Screws that were placed in the body of the sacrum in some dogs resulted in the fewest loosened fixations (12%, 2 of 17), compared to other locations of screw placement. The fixation had loosened in 7% (1 of 14) of dogs that had a cumulative screw depth/sacral width of 60% or more, compared with 48% of dogs (10 of 21) where cumulative screw depth was less than 60%. The number of screws per fixation and whether the separation was fully reduced or not did not affect whether the fixation loosened.  相似文献   

15.
Reasons for performing study: Sacroiliac joint injuries can cause poor performance; however, the interaction between pelvic mechanics and the sacroiliac joint is poorly understood. Objective: To measure pelvic displacement during 3D sacroiliac joint loading. Methods: Nine reflective triads were attached rigidly to bony prominences in sacropelvic specimens harvested from 14 horses for stereophotogrammetric analysis of triad displacements and joint kinematics. The sacrum was coupled to a load cell and mounted vertically within a material testing system (MTS). A pneumatic actuator was used to apply 90 Nm moments to the ischial arch to simulate nutation‐counternutation and left and right lateral bending of the sacroiliac joints. Axial rotation of the sacrum was induced by torsion of the upper MTS fixture. Vectors of marker displacement within orthogonal planes of motion were measured during loading of the sacropelvic specimens. Comparisons in the magnitude and direction of triad displacements were made between paired left‐right markers and paired loading conditions. Results: Nutation‐counternutation of the sacroiliac joint caused vertical displacement of the ischial tuberosities and cranial‐caudal displacement of the wings of the ilium. Lateral bending induced rotational displacement within the horizontal plane of all pelvic landmarks, relative to the sacrum. Axial rotation of the sacrum caused elevation of the wing of the ilium ipsilateral to the direction of sacral rotation and depression of the contralateral ilial wing. Significant paired left‐right differences occurred during most sacroiliac joint loading conditions. Comparable magnitudes of pelvic displacement were measured during nutation‐counternutation, left and right lateral bending, and left and right axial rotation. Conclusions: The equine pelvis is not a rigid structure and asymmetric pelvic deformation occurs during most sacroiliac joint movements. Clinical relevance: Bony pelvic deformation should be considered a normal response to any sacroiliac joint movement.  相似文献   

16.
REASONS FOR PERFORMING STUDY: Sacroiliac joint osteoarthritis has been recognised as a significant cause of poor performance in competition and racehorses. Reliable diagnostic tools are currently lacking. The diagnosis has been based typically on exclusion of other possible causes of poor performance, back pain and hindlimb lameness. OBJECTIVES: To develop a safe, reliable and minimally invasive periarticular or intra-articular injection technique of potential use for diagnosis and therapy of sacroiliac joint disease in horses. METHODS: Twenty-six horses were used to develop and assess a medial approach to the sacroiliac joint with a 15 gauge, 25 cm long spinal needle. In Part I, the cadaveric study, the spinal needle was introduced cranial to the contralateral tuber sacrale and advanced along the medial aspect of the ipsilateral iliac wing until the dorsal surface of the sacrum was encountered. One ml methylene blue (MB) was injected in both sacroiliac joint regions of the sacropelvic specimens. The location of MB-stained tissues relative to the sacroiliac joints was recorded after dissection and disarticulation of the sacroiliac joint. In Part II, the in vivo study, 18 horses were used to validate the in vivo application of the sacroiliac joint injection technique. Horses were restrained in stocks and sedated in preparation for needle placement. One ml MB was injected bilaterally prior to euthanasia. Stained tissues were identified and recorded at necropsy. Successful joint injections were characterised as having MB located intra-articularly or < or = 2 cm periarticularly from the sacroiliac joint margin and localised to the middle or caudal third of the sacroiliac joint. RESULTS: Intra-articular MB was not observed in any specimen. However, MB-stained tissue was identified periarticularly in all injection sites (n = 48). Based on the predetermined success criteria, 96% of the methylene blue depots were located at the middle or caudal third of the sacroiliac joint. Dye-stained tissue was located < or = 2 cm from the sacroiliac joint margins in 88% of the specimens. Median distance of the MB from the sacroiliac joint margins was 1.0 cm (range 0.2-3.8 cm). The overall success rate considering both location and distance of the MB-stained tissue relative to sacroiliac joint margins was 83% (40 of 48 joints). CONCLUSIONS: The injection technique provides a reliable, easy to perform and consistent access to the medial periarticular aspect of the sacroiliac joint. POTENTIAL RELEVANCE: The described injection technique has the potential for both diagnostic and therapeutic applications in the medical management of equine sacroiliac joint disease. Further investigation is necessary to evaluate clinical efficacy and potential adverse effects.  相似文献   

17.
OBJECTIVE: To compare mechanical properties and failure characteristics of 2 methods of fixation for repair of a transverse, midbody fracture of the proximal sesamoid bone (PSB): 4.5-mm AO cortical bone screw (AO) placed in lag fashion and 4/5-mm Acutrak (AT) self-compressing screw. STUDY DESIGN: An in vitro biomechanical evaluation of intact forelimb preparations and forelimb preparations with a simulated midbody PSB fracture stabilized by a bone screw. SAMPLE POPULATION: Sixteen paired and 8 unilateral cadaveric equine forelimbs. METHODS: A midbody transverse osteotomy was created in the medial PSB of bilateral forelimbs of 8 equine cadavers. The osteotomized PSB in 1 forelimb from each cadaver was repaired with an AO screw. The osteotomized PSB in each contralateral limb was repaired with an AT screw. Eight unilateral intact control limbs were also studied. Mechanical properties were determined from axial compression, single cycle to failure, load-deformation curves. Failure characteristics were determined by evaluation of video images and radiographs. RESULTS: No statistically significant differences were found between repair groups. Both AO and AT groups had significantly lower mechanical properties than intact limbs except for stiffness. CONCLUSION: AO and AT constructs were mechanically comparable when used to stabilize a simulated midbody fracture of the medial PSB. Both constructs were mechanically inferior to intact limbs. Clinical Relevance- The AT screw should be considered for clinical use because of the potential for less soft tissue impingement and superior biocompatibility compared with the stainless-steel AO screw. However, postoperative external coaptation is necessary to augment initial fracture stability for either fixation method, and to maintain a standing metacarpophalangeal joint dorsiflexion angle between 150 degrees and 155 degrees.  相似文献   

18.
Ventrodorsal radiographs of the pelvis (n=150) of Rottweilers, Golden Retrievers, and German Shepherd dogs and macerated spines (n=800) from a variety of breeds were assessed for morphological evidence of lumbosacral transitional vertebrae as well as for factors that might lead to radiographic misinterpretation of this condition. Those alterations closely resembling the radiographic appearance of transitional vertebrae were identified to be: (1) calcification of the dorsal and ventral sacroiliac ligaments (=pseudolumbarisation), which might be interpreted as a costal process at S1 (or the corresponding vertebra in cases of numerical vertebral variations); and (2) osteophyte formation at the lumbosacral junction simulating separation of the cranial articular processes from the assembly of the sacral wing as seen in transitional vertebrae.  相似文献   

19.
OBJECTIVE: To determine the ratio of ventral-to-dorsal transverse diameters between the wings of the sacrum on ventrodorsal radiographic views of the pelvis in large dogs and to validate the reliability of this morphometric analysis for functional interpretation. SAMPLE POPULATION: Pelvic specimens from 40 large-breed dogs and radiographs of 113 large-breed dogs. PROCEDURE: In an anatomic and radiographic evaluation, the transverse dorsal diameter (TVDS) and transverse ventral diameter (TVV) between the wings of the sacrum were evaluated in sacrum specimens and on corresponding radiographs of the pelvis and sacrum. The ratio between TVV and TVDS (VD ratio) was calculated. Intraobserver reliability was determined by calculation of the coefficient of variation. In a retrospective radiographic evaluation, the VD ratio was determined in Rottweilers, Golden Retrievers, and German Shepherd Dogs. Correlations between VD ratio and breed, age, and sex were tested. RESULTS: The VD ratio was significantly higher in Rottweilers than in Golden Retrievers and German Shepherd Dogs, denoting an oblique alignment of the sacral wings in Rottweilers (ie, the dorsal aspects of the sacral wings were located more medially than the ventral aspects) and an almost sagittal alignment in the other breeds. The VD ratio was significantly associated with age but not with sex. CONCLUSIONS AND CLINICAL RELEVANCE: Sagittal alignment of the wings of the sacrum is considered to be biomechanically less efficient. These results provide a basis for further studies to evaluate radiographic assessment of the sacroiliac joints similar to the evaluation for hip dysplasia.  相似文献   

20.
REASON FOR PERFORMING STUDY: The traditional techniques for injection of the sacroiliac (SI) region are based on external landmarks. Because of the depth of the SI joint and pathological modifications, SI injections are sometimes challenging in horses. HYPOTHESIS: An ultrasound-guided techniques would allow placement of the needle without depending on external landmarks. METHODS: Fourteen pelvic specimens were isolated from mature horses. A 20 cm bent spinal needle was positioned with ultrasonographic guidance under both iliac wings aiming for SI joints using 5 approaches: cranial, craniomedial, medial and 2 caudal approaches. The length of needle inserted was recorded and 2 ml of latex injected. The distance from latex to the closest sacral articular margin, the contact between latex and the SI interosseous ligament or the contact with the neurovascular structures emerging from the greater sciatic foramen were recorded at the time of dissection. RESULTS: Latex was identified under the iliac wing in all injections but one. The distance from the latex to the closest sacral articular margin was significantly shorter (P = 0.02) for the 2 caudal approaches compared to the cranial, craniomedial and medial approaches. Contact between latex and the SI interosseous ligament was significantly more frequent (P = 0.01) with the cranial, craniomedial and medial approaches (38/73) compared to the caudal approaches (1/24). Contact between latex and the neurovascular structures was significantly less frequent (P = 0.005) for the cranial and craniomedial approaches (0/47) compared to the medial and caudal approaches (8/60). Four erratic injections were encountered. CONCLUSIONS: Ultrasonographic guidance allowed the needle to engage under the iliac wing without being dependent on external landmarks. The caudal approaches allowed deposition of liquid extremely close to the SI joint although retroperitoneal injections occurred. CLINICAL RELEVANCE: Each approach has advantages/drawbacks that could be favoured for selected purposes, but additional work is required to evaluate them on clinical cases.  相似文献   

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