Reliability of Fossae Lumbales Laterales and Pelvic Incidence for Estimating Transsacral Corridors Assessed Using Reconstruction Computed Tomography

Abstract

Background The present study aimed to evaluate the effect of fossae lumbales laterales and pelvic incidence (PI) on transsacral corridors. Methods Patients who underwent pelvic computed tomography (CT) during routine therapy in a single center between 2015 and 2020 were retrospectively reviewed. The patients’ age and sex were documented during CT examination. Measurements were performed for both the upper and second sacral segments. Height and weight of the patients were determined using appropriate tools and body mass index (BMI) was calculated. Transsacral corridors were identified in true coronal and true sagittal planes and their width was determined as the maximum gap measured so that no screws could come out of the transacral corridors. PI was measured. Results Our study included 244 (57%) male and 184 (43%) female patients, who had a mean age of 49.3 ± 14.15 years (range, 18–89 years) and a mean BMI of 26.57 ± 2.38 kg/m 2 . No statistically significant correlation was found between the detection of the dimple sign in physical examination and the presence of an adequate corridor. The PI was statistically significantly higher in the patients with dimples ( p < 0.001). PI of the female patients was higher than that of the male patients ( p = 0.026). The correlation between PI and the existence of adequate corridors for S1 and S2 screws was not statistically significant ( p = 0.858 and p = 0.129, respectively). On the relationship between the presence of adequate S1 and S2 corridors where transsacral screws could be sent, an inverse relationship was detected: if the S1 transsacral corridor was adequate, the S2 corridor was inadequate or vice versa. Conclusions We could not obtain meaningful results on the use of the dimples of Venus or PI instead of CT to evaluate the adequacy of transverse corridors. Nevertheless, we confirmed that an increased PI was associated with the presence of dimples of Venus.

Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint

“…On the study on whether the dimple of Venus can be utilized to evaluate and predict pelvic torsion showed that the dimple did not significantly predict pelvic torsion [22]. Balta et al [5] did not find a statistically significant relationship between the dimple of Venus and sacral anatomy in terms of sacral screw corridor. Despite being widely used, the PIA at the spinopelvic junction cannot be estimated from any anatomical landmark and physical or anthropometric examination findings [23].…”

“…Imagama et al [ 4 ] described the relationship between low PIA and intervertebral disc degeneration. A recent study has revealed the relationship between the dimple of Venus and increased PIA [ 5 ].…”