title: Navigation-aided visualization of lumbosacral nerves for anterior sacroiliac plate fixation: a case report.
abstract: BACKGROUND
  Anterior sacroiliac joint plate fixation for unstable pelvic ring fractures avoids soft tissue problems in the buttocks; however, the lumbosacral nerves lie in close proximity to the sacroiliac joint and may be injured during the procedure.
  
  
  METHODS
  A 49 year-old woman with a type C pelvic ring fracture was treated with an anterior sacroiliac plate using a computed tomography (CT)-three-dimensional (3D)-fluoroscopy matching navigation system, which visualized the lumbosacral nerves as well as the iliac and sacral bones. We used a flat panel detector 3D C-arm, which made it possible to superimpose our preoperative CT-based plan on the intra-operative 3D-fluoroscopic images.
  
  
  RESULTS
  No postoperative complications were noted.
  
  
  CONCLUSIONS
  Intra-operative lumbosacral nerve visualization using computer navigation was useful to recognize the 'at-risk' area for nerve injury during anterior sacroiliac plate fixation.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Takao
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakai
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Sugano
mesh_terms: D001860:Bone Plates; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008160:Lumbosacral Plexus / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries* / Q000294:innervation / Q000601:surgery*; D012446:Sacroiliac Joint / Q000293:injuries* / Q000294:innervation / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: anterior sacroiliac plate fixation; computed tomography; lumbosacral nerve; navigation; three-dimensional fluoroscopy