A posterior approach for inspection of reduction of sacroiliac joint disruption

This anatomic study was undertaken to describe a new posterior approach ena bling direct inspection of reduction of sacroiliac joint disruption (SIJD), and guidance of iliosacral screw placement. The reduction of SIJD is usual ly monitored by inspection of the opposing sacrum and ilium at the posterio r margin of the greater sciatic notch and there is a relative lack of infor mation concerning inspection of reduction of SIJD from the posterosuperior aspect of the sacroiliac joint surface. Ten cadavers were dissected to dete rmine the possibility of inspecting reduction of SIJD from the posterosuper ior aspect of the sacroiliac joint by means of a posterior approach which p assed immediately lateral to the deep back muscles and the fifth lumbar tra nsverse process. The results indicated that the posterosuperior aspect of t he sacroiliac joint surface and sacral ala can be directly palpated or visu alised. This approach facilitates improved access for inspection of reducti on of SIJD and guidance of iliosacral screw placement.