Recent Progress in the Classification and Operation of Sacral Fractures

Abstract

Most sacral fractures are caused by high-energy, violent injuries, often accompanied by lumbosacral plexus injuries, which can cause instability of the posterior pelvic ring or lumbosacral junction in severe cases. Currently, the most commonly used clinical classification methods are Denis classification, Tile classification, Isler classification, and Denis II classification. In recent years, lumbosacral vertebral injury classification and injury degree scoring systems have often been applied clinically as the choice of treatment methods. At present, the internal fixation and implantation methods of sacral fracture are developing in the direction of positive, efficient, safe, and minimally invasive. But different fixation methods have their own indications, which should be strictly followed. This article reviews the classification of sacral fractures and the latest progress in surgical treatment.

Sacroplasty for Sacral Insufficiency Fractures: Narrative Literature Review on Patient Selection, Technical Approaches, and Outcomes

“…However, with advanced imaging now showing a higher prevalence of osteoporotic-and stress-related sacral fractures, management based solely on these classification systems is no longer widely agreed upon. This is because these systems emphasize high-energy traumatic mechanisms, often with associated neurologic or pelvic ring injuries, that may warrant more aggressive interventions such as sacroiliac screws or spinopelvic fixation, than sacral insufficiency fractures [18]. Appropriate decision-making between surgical or non-surgical management requires an understanding that sacral insufficiency fractures frequently present in older patients with low bone mineral density following low energy injuries and, as such, create progressive instability from the accumulation of additional fractures [19].…”

Could nerve transplantation be the future of this field: a bibliometric analysis about lumbosacral plexus injury

“…While trauma-induced lumbosacral plexus injuries are relatively uncommon due to the protective shield of muscles and bones, this protection also poses significant treatment challenges 2 . Furthermore, in recent years, lumbosacral plexus injuries have been on the rise due to various factors such as lower limb nerve blocks, surgical mishaps, pelvic radiation therapy, and poisonings 3 , 4 . These diverse causes can cause severe damage to the lumbosacral nerves, leading to a lifetime of lower limb motor and sensory pain, as well as urinary and bowel disorders, substantially diminishing the quality of life for affected individuals.…”