THE PROBLEM OF SACRAL DISMORPHISM IN ORTHOPEDICSURGERY AND TRAUMATOLOGY: LITERATURE REVIEW

Abstract

Introduction. Anatomical differences in the relationship between the lumbar spine and the sacrum continue to play an
important role in the formation of spinal deformities, low back pain, and pelvic injuries.
The aim of the study is analysis of literary sources on various types of sacral dysmorphism, associated pathological
conditions, their diagnosis and surgical correction
Search strategy. A search was conducted for literature sources published in English in the PubMed, Scopus, Web of
Science, Embase database over the past 10 years, using the keywords: “sacral dysmorphism”, “lumbosacral transitional
vertebrae”, “LSTV”, “transitional lumbosacral vertebrae”. A total of 131 relevant publications were found according to the
selection criteria, of which 32 relevant scientific publications were taken into the analysis. Results. Various types of sacral dysmorphism are described in several classifications, the most famous of which is the
Castellvi-Chan classification (1984). Authors of various studies have established a statistically significant association
between sacral dysmorphism and sacroiliac dysfunction, as well as between low back pains. Percutaneous sacroiliac screw
fixation under fluoroscopic guidance is an effective method for stabilizing the pelvis. However, due to sacral dysmorphic
disorder, the placement of sacral screws becomes impossible or very difficult.
Conclusion. When preoperatively planning surgical fixation of the posterior ring of the pelvis, it is necessary to take into
account the need to identify dysmorphic characteristics, and if they are present, to select the safest bone corridor based on
the analysis of computed tomograms and prepare the appropriate tools for surgical techniques. In addition, it is necessary to
analyze the bone mineral density between S1 and S2 in normal and dysmorphic sacrum.