OBJECTIVETo investigate the best effective and accepted path of iliac screws for lumbar sacral spine and pelvis to provide reference for reconstruction.

METHODSFrom Feb. 2009 to Aug. 2009, radiographic data of 50 patients were selected for various reasons, pelvic CT scanning and three-dimensional reconstruction and no positive performance, included 28 males and 22 females with an average age of 41.2 years old, ranging from 19 to 65 years. Designed four paths, in path A, B, C, CLIC (crossing point of Chiotic line and posterior iliac crest, located 24 mm on the top of posterior superior iliac spine) was the starting point for the path in the direction of the upper edge of the acetabulum, anterior inferior iliac spine, acetabulum center; in path D, the posterior superior iliac spine was starting point to direct anterior inferior iliac spine. The length of the screw channel and two narrow points in the screw channel of the bone plate thickness data of each different path were measured and analyzed.

RESULTSThe path A (CLIC point to the upper edge of the acetabulum) and the path B (CLIC point to the AIIS) and the path D (PSIS to AIIS) had correspond length of the screw channel, but the thickness of iliac of path A was thicker than that of path B and D. The iliac thickness of path A (CLIC point to the upper edge of the acetabulum) and the path C (CLIC point to the acetabular center) has no significant difference, but the channel length of path A was significant longer than that of path C.

CONCLUSIONPath A from the CLIC point to the direction of the upper edge of acetabular ilium nail route was the longest path and the iliac bone plate was the most thick, and able to accommodate the relatively longest and most coarse iliac screw, but also bear the greatest tension. It is the best iliac nail route.