risk of spermatic cord injury during anterior pelvic ring and acetabular surgery: an anatomical study
نویسندگان
چکیده
background: anterior pelvic ring surgery includes a variety of plating techniques and insertion of retrograde superior pubic ramus screws. anterior acetabular surgery also includes fixation through an ilioinguinal or stoppa approach. these exposures risk injury to the spermatic cord and accompanying genital branch of the genitofemoral nerve. the primary aim of this study was to identify the distance between the midline and the spermatic cords in adult male cadaveric specimens. the secondary aim was to determine spermatic cord diameters and measure the distance between the spermatic cord and implant during instrumentation of a retrograde superior pubic ramus medullary screw. methods: extended pfannenstiel and stoppa approaches were performed on 18 embalmed male cadavers bilaterally. spermatic cord characteristics were recorded and a number of measurements were performed to determine the distance of implants and the midline from the spermatic cord. results: the average distance between the midline and spermatic cords was 34.2 mm. the average distance between the spermatic cord and implant was 18.2 mm. eleven of the thirty-six dissections had abnormalities including cord lipomas and inguinal hernias. the average cord diameter was 18.6 mm. the average cord diameter in those with abnormalities was 24.9 mm and 16 mm in those without abnormalities, this difference was statistically significant. discussion: due to the proximity of the spermatic cord, the surgeon should either formally expose the cord or limit lateral dissection from the midline during pfannenstiel and stoppa exposures. similarly, the surgeon should use soft-tissue sleeves and oscillating drills to avoid injury to the contralateral spermatic cord during the insertion of retrograde superior pubic ramus medullary screws.
منابع مشابه
Risk of Spermatic Cord Injury During Anterior Pelvic Ring and Acetabular Surgery: An Anatomical Study
Background: Anterior pelvic ring surgery includes a variety of plating techniques and insertion of retrograde superior pubic ramus screws. Anterior acetabular surgery also includes fixation through an ilioinguinal or Stoppa approach. These exposures risk injury to the spermatic cord and accompanying genital branch of the genitofemoral nerve. The primary aim of this study was to identify the d...
متن کاملRisk of Spermatic Cord Injury During Anterior Pelvic Ring and Acetabular Surgery: An Anatomical Study.
BACKGROUND Anterior pelvic ring surgery includes a variety of plating techniques and insertion of retrograde superior pubic ramus screws. Anterior acetabular surgery also includes fixation through an ilioinguinal or Stoppa approach. These exposures risk injury to the spermatic cord and accompanying genital branch of the genitofemoral nerve. The primary aim of this study was to identify the dist...
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Acetabular reconstruction cages are indicated for severe combined segmental and cavitary acetabular bone defects. The purpose of this study was to evaluate the implications of screw placement and drill plunge and the potential insult to anatomical structures when implanting acetabular reconstruction cages. A segmental cavitary defect was reamed into the acetabulum and a cage was implanted in ea...
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Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnorma...
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عنوان ژورنال:
the archives of bone and joint surgeryجلد ۳، شماره ۴، صفحات ۲۶۹-۲۷۳
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