Lumbosacral and Spinopelvic Fixation in Spine Surgery

Achieving fusion across the lumbosacral region has been a challenge in spine surgery since the advent of spinal instrumentation. The unique anatomy of this region and various biomechanical forces are some of the main reasons for the difficulty of attaining fusion in the setting of complex deformities in the lumbosacral region. Pelvic fixation has allowed for some success, although instrumentation still remains challenging. In this article we have reviewed the history of this problem with a focus on the development of various instrumentation techniques. We conclude by presenting a novel technique of S2-iliac screw fixation to address some of these challenges.