Historical Perspectives on the Evolution of Spino-Pelvic Fixation and its Implications on Clinical Care A Narrative Review

Study Design: Broad narrative review. Objectives: To review and summarize the evolution of spinopelvic fixation (SPF) and its implications on clinical care. Methods: A thorough review of peer-reviewed literature was performed on the historical evolution of sacropelvic fixation techniques and their respective advantages and disadvantages. Results: The sacropelvic junction has been a long-standing challenge due to a combination of anatomic idiosyncrasies and very high biomechanical forces. While first approaches of fusion were determinated by many material and surgical technique-related limitations, the modern idea of stabilization of the lumbosacral junction was largely initiated by the inclusion of the ilium into lumbosacral fusion. While there is a wide spectrum of indications for SPF the chosen technique remains is defined by the individual pathology and surgeons’ preference. Conclusion: By a constant evolution of both instrumentation hardware and surgical technique better fusion rates paired with improved clinical results could be achieved.