Study design: Literature-based topic review.
Objective: To review the indications and techniques for different sacropelvic fixation methods and to outline important associated complications.
Summary of background data: Despite all the advances and new developments in spinal instrumentation techniques, fixation at the lumbosacral junction continues to be one of the important challenges to spine surgeons. The poor bone quality of the sacrum, the complex regional anatomy, and the tremendous biomechanical forces at the lumbosacral junction contribute to the high rates of instrumentation-related problems. Although many techniques for sacropelvic fixation have been attempted, only a few are still widely used because of the high rate of complications associated with some of those techniques.
Methods: Review of literature and expert opinion.
Conclusion: There are many indications for sacropelvic fixation. Long fusions to the sacrum are the most common reasons for extending the instrumentation to the pelvis. Spinal surgeons performing complex spinal reconstruction should be familiar with the currently available techniques, including their potential risks and complications. Surgical treatment decisions should be based on an individual patient's anatomy and abnormalities, and on the surgeon's experience.