Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

Sasaji, Tatsuro; Imaizumi, Hideki; Takano, Hiroyuki; Saitoh, Hideo; Murakami, Taishi; Kanabuchi, Ryuichi; Sekiya, Motohiko

doi:10.1155/2016/9412315

Cited by 3 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been case reports of sacral alar fatigue fractures occurring after the treatment of lumbar spondylolysis 19 . Notably, more than half of the cases in this study were found to have complications with spondylolysis.…”

Section: Discussionmentioning

confidence: 99%

Features of sacral alar fatigue fractures in adolescent athletes with overuse

Tatsumura

Eto

Nagashima

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Three types of sacral alar fatigue fractures are elderly, postnatal, and sport-related. They are most prevalent in athletes during adulthood; there are few reports of sacral alar fatigue fractures in young athletes. The purpose of this study was to analyze sacral alar fatigue fractures in adolescent athletes. Of the 920 patients hospitalized with low back pain, 13 were diagnosed with sacral alar fatigue fractures with magnetic resonance imaging (MRI) abnormalities. We investigated age, sex, sports discipline, span from symptom onset to consultation, laterality, complication with spondylolysis, computed tomography (CT) findings, and treatment span. The average age was 14.5 years old (8-men and 5-women). The most frequent discipline was basketball. The span to consultation was 13.2 days. The number of right-side cases was 9. Seven cases were complicated by bilateral spondylolysis. MRI abnormalities were observed in all the cases. Only two patients showed abnormal findings on CT. Averagely 67 days after treatment, participants returned to their sports. Sacral alar fatigue fractures suggest that the span from onset to consultation is short. Fracture lines are often unclear on CT, and MRI is useful for diagnosis. More than half of the cases in this study were complicated by lumbar spondylolysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Features of sacral alar fatigue fractures in adolescent athletes with overuse

Tatsumura

Eto

Nagashima

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…15,23 Second, the presence of spondylolysis may contribute to a diminished posterior support component in the lumbar spine, increasing the occurrence of sacral fatigue fractures. 31,39 The fracture line was present on the sacral ala in all cases, unilateral in most patients but bilateral in 4 patients. In all patients with identified fracture lines, oblique fracture lines were observed extending from the S1 foramen to the sacral ala.…”

Section: Imaging Findingsmentioning

confidence: 95%

Clinical Features and Therapeutic Process of Sacral Fatigue Fractures in Adolescents

Hiranaka,

Miyazaki,

Inoue

et al. 2024

Am J Sports Med

View full text Add to dashboard Cite

Background: Sacral fatigue fractures are a rare injury but should be considered as a differential diagnosis for low back and buttock pain in young adults. Collective reports are limited, most of which have focused on long-distance runners. Purpose: To investigate the characteristics of sacral fatigue fractures in adolescents. Study Design: Case series; Level of evidence, 4. Methods: We analyzed patient background characteristics, physical examination and imaging findings, and treatment courses of those diagnosed with sacral fatigue fractures using magnetic resonance imaging. Results: Among 34 patients with sacral fatigue fractures, 15 and 19 were male and female patients, respectively, with an age range of 11 to 19 years (mean age, 15.0 years). Almost all patients were athletes, and 29 patients performed their sport ≥5 times a week. Long-distance runners were the most commonly affected, comprising 7 patients, and participants in other common sports such as baseball (6 patients), basketball (4 patients), and soccer (3 patients) were also affected. Physical examination revealed tension sign (Lasègue test) on the affected side in 6 patients and tight hamstrings in 24 patients. Imaging findings included 18 patients with right-side involvement, 12 with left-side involvement, and 4 with involvement on both sides. In 11 patients, spina bifida occulta was observed at S1 and 8 patients had a history of lumbar spondylolysis with 4 patients having concurrent sacral fatigue fractures. Physical therapy was performed concurrently with the cessation of exercise, and return to exercise was permitted if the pain had been relieved after 1 month. All patients returned to sports at a median of 48 days (range, 20-226 days) after symptom onset. However, 2 patients experienced recurrence (1 patient on the ipsilateral side and 1 patient on the contralateral side). Conclusion: Sacral stress fractures are not limited to long-distance runners in this population and can manifest as lower back pain or buttock pain in athletes participating in a variety of sports. Although the course of treatment was generally good, the possibility of recurrence must always be considered.

show abstract

Initial stability of one-stage anterior debridement and cage implantation combined with anterior-lateral fixation by a dual screw-rod construct in the treatment of lumbosacral tuberculosis: a cadaveric biomechanical study

Liu

Gao

et al. 2019

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Although various surgical methods are used to treat lumbosacral tuberculosis, no unified surgical approach exists. Thus, exploring an optimal operation method has substantial clinical importance. Evaluate the initial stability of a new surgical method, a one-stage anterior debridement and cage implantation combined with anterior-lateral fixation by a dual screw-rod construct, in the treatment of lumbosacral tuberculosis and provide biomechanical support for its further promotion in clinical applications. Methods Fifteen fresh human lumbosacral spine specimens without fractures, deformities or osteoporosis were randomly divided into intact (I), anterior fixation (AF) and posterior fixation (PF) groups. All AF and PF group specimens had subtotal resections of the L5 vertebra and adjacent discs, while the I group specimens were kept intact. Then, titanium cages were implanted in the surgical site and a dual screw-rod construct was fixed anterior-laterally in the AF group, while the PF group specimens were fixed posteriorly with only the dual screw-rod construct. Mechanical tests were conducted for initial stability evaluations. Results The load at the maximum displacement (5 mm) or rotation angle (5 °) was less for the I group specimens than for the AF and PF group specimens in all directions ( P < 0.05). The load at the maximum displacement (5 mm) was greater for the AF group specimens than for the PF group specimens in flexion, lateral bending and axial compression ( P < 0.05) and lower than in the PF group specimens in extension ( P < 0.05). In torsion, there was no difference between the loads in the AF and PF groups at the maximum rotation angle (5 °) ( P > 0.05). Conclusions: The proposed surgical approach can provide better immediate stability than anterior debridement with posterior dual screw-rod fixation in the treatment of lumbosacral tuberculosis in flexion, lateral bending and axial compression.

show abstract

Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

Cited by 3 publications

References 19 publications

Features of sacral alar fatigue fractures in adolescent athletes with overuse

Features of sacral alar fatigue fractures in adolescent athletes with overuse

Clinical Features and Therapeutic Process of Sacral Fatigue Fractures in Adolescents

Initial stability of one-stage anterior debridement and cage implantation combined with anterior-lateral fixation by a dual screw-rod construct in the treatment of lumbosacral tuberculosis: a cadaveric biomechanical study

Contact Info

Product

Resources

About