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.
Keywords: S2AI; fixation; ilium; lumbopelvic; pelvic; sacropelvic.