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Pelvic Fixation in Spine SurgeryHistorical Overview, Indications, Biomechanical Relevance, and Current Techniques
Ali Moshirfar, MD; Frank F. Rand, MD; Paul D. Sponseller, MD; Stephen J. Parazin, MD; A. Jay Khanna, MD; Khaled M. Kebaish, MD; John T. Stinson, MD; Lee H. RileyIII, MD
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Dec 01;87(suppl 2):89-106. doi: 10.2106/JBJS.E.00453
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Fusions of the lumbosacral spine continue to be a challenging area in spine surgery. The complex local anatomy, unique biomechanical forces, and poor bone quality of the sacrum are just a few of the many reasons why fusions of the lumbosacral spine have been notoriously difficult to perform.The goals of this review were (1) to familiarize the reader with the complicated anatomy of the lumbosacral region, the specific pathological entities that involve this region, and the biomechanical forces that lead to high pseudarthrosis rates; (2) to discuss the various types of lumbosacral and spinopelvic implants and their respective advantages and disadvantages; (3) to review the most common clinical indications for lumbosacral and spinopelvic fusions; and (4) to emphasize that iliac screw placement is a safe and reproducible technique for achieving stable caudad pelvic fixation that minimizes the risk of pseudarthrosis at the lumbosacral junction.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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