Injuries of the Lumbar Spine Associated with Sacral Fractures

Shvets A.I. Shvets A.I., D.V. Ivchenko, V.K. Ivchenko, A.A. Lubenets, A.V. Ivchenko

Abstract


The objective of the study is analysis of the sacral and sacroiliac joints injuries associated with lumbosacral spine injuries and the development of the method of onestage reconstruction of the damaged segment and its surgical fixation to provide immediate mobilization of patient, early weight bearing.
Material and Methods. One case (2 %) among the 46 cases of injuries with involvement of the dorsal half of the pelvis was unstable comminuted U-shaped sacral fracture combined with compressed, burst fracture of the body of L5 A3.3, with narrowing of the spinal canal up to 80 % and cauda equina injury (Frankel C). Onestage surgery was performed: open dorsal decompression of the dural sac with reconstruction of the spinal canal and the stabilization of the lumbosacral spine by transpedicular construction in the form of lumbosacroiliac spondylosyndesis.
Results. Pain in the legs of patient decreased immediately after operation to the level of VAS 4–5 and in three weeks after the operation — to VAS 2–3 points, neurological disorders recovered to Frankel D level.
Conclusions. One stage reconstructive surgery with lumbosacroiliac spondylosyndesis has to be performed in cases of unstable comminuted sacral injuries combined with unstable injuries of L5 vertebral body.


Keywords


sacral fractures; instability; fractures of the lumbar vertebrae; spinal stenosis; decompression

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DOI: https://doi.org/10.22141/1608-1706.2.15.2014.81359

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