What does this research mean for the field?

The safe zone for bicortical S1 pedicle screw placement is defined, with venous structures being closer to the mid-sacral promontory than arterial structures, indicating a need for careful medial and inferior screw direction to minimize neurovascular injury. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to define the anatomical relationships and variations of neurovascular structures around the lumbosacral junction to establish a safe zone for screw placement.

March 13, 2026National Journal of Clinical AnatomyOpen Access

Anatomical Variations of Structures around the Lumbosacral Junction and Determination of the Safe Zone for Bicortical S1 Pedicle Screw Placement: A Cadaveric Study

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The study aims to define the anatomical relationships and variations of neurovascular structures around the lumbosacral junction to establish a safe zone for screw placement.
Conducted a cadaveric study involving 22 fresh or embalmed cadavers.
Used a midline longitudinal incision to expose major vessels.
Measured spatial relationships of vessels with the sacral promontory and vertebrae.
The left common iliac vein was closer to the mid-sacral promontory than the right.
The vascular safe zone measured 19.09 mm on the right and 17.68 mm on the left.
S1 nerve roots were closer to vascular structures than L5 nerve roots.

Discussion

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Implication

Cadaveric study defines S1 pedicle screw safe zone in proximity to neurovascular structures, suggesting clinical guidelines.

Cite This Study

Kurmi et al. (2026) studied this question.

synapsesocial.com/papers/69b3ac2b02a1e69014ccdb07 https://doi.org/10.4103/njca.njca_48_25

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Anatomical Variations of Structures around the Lumbosacral Junction and Determination of the Safe Zone for Bicortical S1 Pedicle Screw Placement: A Cadaveric Study

Key Points

Discussion

Implication

Cite This Study

Anatomical Variations of Structures around the Lumbosacral Junction and Determination of the Safe Zone for Bicortical S1 Pedicle Screw Placement: A Cadaveric Study

Key Points

Discussion

Implication

Cite This Study

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