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


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.


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


Alegre G.M. S1 screw bending moment with posterior spinal instrumentation across the lumbosacral junction after unilateral iliac crest harvest / G.M. Alegre, M.C. Gupta, B.K. Bay et al. // Spine. — 2001. — 26. — P. 1950-1955.

Angthong C. Complex lumbosacral fracture-dislocation with pelvic ring disruption and vertical shear sacral fracture: a case report of late presentation and review of the literature / C. Angthong, S. Wunnasinthop, S. Sanpakit // Turkish Journal of Trauma & Emergency Surgery. — 2010. — 16(6). — P. 561-566.

Griffin D.R. Vertically unstable pelvic fractures fixed with percutaneous iliosacral crews: does posterior injury pattern predict fixation failure / D.R. Griffin, A.J. Starr, C.M. Reinert et al. // J. Orthop. Trauma. — 2003. — 17. — P. 399-405.

Leong J.C. Comparison of the strengths of lumbosacral fixation achieved with techniques using one and two triangulated sacral screws / J.C. Leong, W.W. Lu, Y. Zheng et al. // Spine. — 1998. — 23. — P. 2289-2294.

Mouhsine E. Modified triangular posterior osteosynthesis of unstable sacrum fracture / E. Mouhsine, M. Wettstein, C. Schizas et al. // Eur. Spine J. — 2006 June. — 15(6). — P. 857-863.

Nork S.E. Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results / S.E. Nork, C.B. Jones, S.P. Harding et al. // J. Orthop. Trauma. — 2001. — 15. — P. 238-246.

Pelle M.W. Comparison of pelvic fixation technique in neuromuscular spinal deformity correction: Galveston rod versus iliac and lumbosacral screws / M.W. Pelle, L.G. Lenke, K.H. Bridwell et al. // Spine. — 2006. — 31. — P. 2392-2398.

Sedat J. One-Stage Percutaneous Treatment in a Patient with Pelvic and Vertebral Compression Fractures / J. Sedat, Y. Chau, C. Razafidratsiva et al. // Cardiovasc. Intervent. Radiol. — 2010. — 33. — P. 219-222.

Stovall D.O. Sacral fixation technique in lumbosacral fusion / D.O. Stovall, J.A. Goodrich, D. Lundy et al. // Spine. — 1997. — 22. — P. 32-37.

Tsirikos A.I. Traumatic lumbosacral dislocation: report of two cases / A.I. Tsirikos, A. Saifuddin, M.H. Noordeen et al. // Spine (Phila Pa 1976). — 2004. — 29. — E164-168.

Tsuchiya K. Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity / K. Tsuchiya, K.H. Bridwell, T.R. Kuklo et al. // Spine. — 2006. — 31. — P. 303-308.

Woo-Tack Rh. Lumbo-sacro-pelvic Fixation Using Iliac Screws for the Complex Lumbo-sacral Fractures / Rh. Woo-Tack, Y. Seung-Hoon, J. Yeon-Gyu et al. // J. Korean Neurosurg. Soc. — 2007 December. — 42(6). — 495-498. — doi: 10.3340/jkns.2007.42.6.495

Copyright (c) 2016 TRAUMA

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2020


   Seo анализ сайта