title: Anatomical Location of the Common Iliac Veins at the Level of the Sacrum: Relationship between Perforation Risk and the Trajectory Angle of the Screw.
abstract: Purpose.To determine the safety of transarticular surface screw (TASS) insertion and the anatomical location of the common iliac veins (CIVs) at the level of the promontorium.Materials and Methods.The locations of the CIVs on 1 mm computed tomography-myelography slices of 50 patients at the level of the promontorium and 20 human cadavers were investigated.Results.Among the patients, the left CIV was closer to the S1 anterior wall than the right CIV (mean distance: 5.0 ± 3.0 and 7.0 ± 4.2 mm, resp.). The level of the inferior vena cava (IVC) formation varied among the cadavers. The mean distance between the IVC formation and promontorium tip was 30.2 ± 12.8 mm. The height of the IVC formation and distance between the right and the left CIVs at the level of the promontorium were significantly correlated (P< 0.001).Conclusion.The TASS trajectory is safe as long as the screw does not penetrate the anterior cortex of S1. The level of the IVC formation can help to predict the distance between the right and the left CIVs at the level of the promontorium. The CIVs do not have a uniform anatomical location; therefore, preoperative computed tomography is necessary to confirm their location.
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Javid
authors.initials: J
authors.lastname: Akhgar
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hidetomi
authors.identifier: 0000-0001-9183-3363
authors.initials: H
authors.lastname: Terai
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Suhrab Rahmani
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tamai
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Toyoda
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hoshino
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Sayed
authors.initials: S
authors.lastname: Abdullah Ahmadi
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002102:Cadaver; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012447:Sacrum / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000000981:diagnostic imaging