To the Editor:

In the paper “Traumatic Spondylopelvic Dissociation" (2005;87:1098- 1103) by Vresilovic, et al, the authors treated two patients with posterior stabilization using spinal instrumentation via a modified Galveston technique. I congratulate the authors for their excellent result.

I would point out that with the exception of Harrington instrumentation, use of modern spinal instrumentation for surgical treatment of pelvic and sacral injuries is not new. In 1995 we began to the use Texas Scottish Rite Hospital instrumentation in pelvic and sacral injuries and in 2000 we published a clinical study with the medium-term results of posterior stabilization of unstable sacroiliac injuries and sacral fractures(1,2). To our knowledge, our study (1) was the first use of a purely modern segmental pedicle instrumentation system for operative treatment of unstable sacroiliac injuries. Additionally,in 2000, Abumi, et al,(3) described the use of spinal instrumentation for iliosacral dislocations using pedicle screws in S1 and connecting them to the lower lumbar spine.

I would also add that I believe that the immobilization of more than two of the lowermost vertebrae in young persons should be discouraged because it immobilizes the most flexible part of the lumbar spine.

Panagiotis G. Korovessis, Ph.D.

References:

1. Korovessis P, Stamatakis M, Baikousis A. Posterior stabilization of unstable sacroiliac injuries with the Texas Scottish Rite Hospital Spinal Instrumentation. Orthopedics 2000; 23: 323-7

2. Korovessis, Panagiotis G. Letter to Editor. Spine. 26(14):1640-1641, July 15, 2001.

3. Abumi, Kuniyoshi MD; Saita, Michinori MD; Iida, Takahiro MD; Kaneda, Kiyoshi Reduction and fixation of sacroiliac joint dislocation by the combined use of S1 pedicle screws and the Galveston technique. Spine 2000;25:1977-83.