PELVİS TİPLERİNİN TRANS-SAKRAL VİDA KORİDOR ÇAPINA ETKİSİNİN DEĞERLENDİRİLMESİ (BİLGİSAYARLI TOMOGRAFİ VERİLERİ KULLANILARAK YAPILAN RETROSPEKTİF ANALİZ.)

Amaç: Bu çalışmanın amacı, pelvis tipinin trans-sakral (TS) vida koridor çapı üzerindeki etkisini araştırmaktır. Yöntemler: 2017 ile 2020 yılları arasındaki pelvis bilgisayarlı tomografi (BT) taramaları retrospektif olarak gözden geçirildi. Hastaların yaş, cinsiyet, boy, kilo ve vücut kitle indeksi (VKİ) CT taraması sırasında belirlendi. Pelvik BT taramaları, görüntüleme sisteminin çok düzlemli rekonstrüksiyon (MPR) modu kullanılarak incelendi ve üst ve ikinci sakral segmentler için TS vida koridoru ölçüldü. Ayrıca, pelvik insidans (PI), sakral eğim (SS) ve pelvik eğim (PT) değerleri ölçüldü. Pelvis tiplemesi büyük transvers çap, anteroposterior çap, interspinöz, intertüberokitoz, transvers çıkış çapı, sagittal orta pelvik çap ve sagittal çıkış değerleri kullanılarak yapıldı. Bulgular: Çalışmaya 81 (%38) erkek ve 132 (%62) kadın hasta dahil edildi. Ginekoid pelvis tipi kadınlarda daha yaygındı, android pelvis ise erkeklerde görüldü (p < 0.001). TS vida koridorundaki en büyük çaplar, S1 seviyesinde antropoid pelvis tipine aitti. Ancak, S2 seviyesinde TS koridorunda, pelvis tipi grupları arasında AP ve CC ortalama değerlerinde anlamlı bir fark vardı (p < 0.001). Cinsiyet farkının S1 ve S2 seviyelerindeki TS vida koridor genişliği üzerindeki etkisi anlamlıydı. TS vida koridoru için uygun bir koridor genişliği, S1 seviyesinde kadınların %50.8'inde ve erkeklerin %67.9'unda, S2 seviyesinde ise kadınların %21.2'sinde ve erkeklerin %70.4'ünde tespit edildi. Sonuçlar: Pelvis tipine ve cinsiyete göre trans-sakral vida koridorunun boyutlarında önemli bir fark bulunmaktadır; en büyük çap antropoid pelvis tipinde ve erkeklerde gözlemlenmektedir. Özellikle erkeklerde ve android-antropoid pelvis yapısına sahip bireylerde, kritik durumlarda trans-sakral vida seçeneği, pelvis posterior halka yaralanmaları için yalnızca S1 trans-sakral koridoru değil, aynı zamanda S2 trans-sakral koridoru için de öncelikli olarak değerlendirilmelidir.

Anahtar Kelimeler:

trans-sakral vida koridoru, Pelvis tipi, Android pelvis, Sakrum kırığı

Evaluation of the Effect of Pelvic Types on Trans-Sacral Screw Corridor Diameter (Retrospective Analysis Using Computerized Tomography Data)

Aims: The aim of this study was to investigate the effect of pelvis type on the trans-sacral(TS) screw corridor diameter. Methods: Pelvis computed tomography (CT) scans between 2017 and 2020 were retrospectively reviewed. Age, gender, height, weight and body mass index (BMI) of the patients were determined during the CT examination. Pelvic CT scans were examined using the imaging system's multi-plane reconstruction (MPR) mode, and the TS screw corridor was measured for both the upper and second sacral segments. In addition, pelvic incidence (PI), sacral tilt (SS), and pelvic tilt (PT) values were measured. Pelvis typing was performed using the large transverse diameter, anteroposterior diameter, interspinous, intertuberocytosis, transverse outlet diameter, sagittal mid-pelvic diameter, and sagittal outlet values. Results: 81(38%) male and 132(62%) female patients were included in the study. Gynecoid pelvis type was more common in females and android pelvis in males (p < 0.001). The largest diameters in the TS screw corridor at the S1 level belonged to the anthropoid pelvis type. However, in the TS corridor at the S2 level, there was a significant difference between the pelvis-type groups in the mean values of AP and CC (p < 0.001). The effect of gender difference on the TS screw corridor width at the S1 and S2 levels was significant. An adequate corridor width for the TS screw corridor was detected in 50.8% of females and 67.9% of males at the S1 level, while in 21.2% of females and 70.4% of males at the S2 level. Conclusions: There is a significant difference in the dimensions of the trans-sacral screw corridor according to the pelvis type and gender, with the largest diameter observed in the anthropoid pelvis type and males. In critical situations, especially in males and individuals with android-anthropoid pelvis, the trans-sacral screw option should be considered primarily not only for the S1 trans-sacral corridor but also for the S2 trans-sacral corridor in pelvic posterior ring injuries

Keywords:

Trans-sacral screw corridor, pelvis type, android pelvis, sacrum fracture,

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