Traumatic Spondylopelvic Dissociation

Bents, Robert T.; France, John C.; Glover, James; Kaylor, Kenneth L.

doi:10.1097/00007632-199608010-00020

Cited by 53 publications

(11 citation statements)

References 21 publications

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“…Lumbopelvic fixation is the standard choice of treatment for cases of unstable multiplanar sacral fracture with spinopelvic dissociation (9, 11–13). Recently gaining popularity, lumbopelvic fixation construct being bilateral triangular osteosynthesis with lumbar pedicle screws (L4 and L5 vertebrae) and a pair of iliac screws connected with rods and commonly supplemented with an iliosacral screw (ISS) to maintain sacral fracture reduction (9, 11, 12, 14–16). However, the use of iliosacral screws is limited to non-comminuted and minimally displaced multiplanar sacral fractures (17, 18).…”

Section: Discussionmentioning

confidence: 99%

Spinopelvic Fixation Supplemented With Gullwing Plate for Multiplanar Sacral Fracture With Spinopelvic Dissociation: A Case Series With Short Term Follow Up

et al. 2019

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We describe a series of three patients who sustained multiplanar sacral fracture with spinopelvic dissociation treated with bilateral triangle osteosynthesis supplemented with a gullwing plate. Multiplanar sacral fracture causes the sacrum to divide into two parts which in severe cases, fracture displacement results in neurological injury. Spinopelvic fixation supplemented with a gullwing plate surgical treatment is still a viable option with an acceptable outcome. The average waiting time prior to surgery is 3 weeks.

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Section: Discussionmentioning

confidence: 99%

Spinopelvic Fixation Supplemented With Gullwing Plate for Multiplanar Sacral Fracture With Spinopelvic Dissociation: A Case Series With Short Term Follow Up

et al. 2019

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“…As the sacrum is a part of the posterior pelvic ring and the intercalary bone between the spine and the pelvis, a fracture may cause spinopelvic dissociation wherein there is a disconnection between the cephalad lumbar spine/central sacrum and the caudad bilateral sacral alae [21,22]. In this situation, a spinopelvic fixation, which is a bilateral lumbopelvic fixation without or with iliosacral fixation, is required to transmit the load from the spine to the ilium bilaterally [22,23].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Study of Posterior Pelvic Fixations in Vertically Unstable Sacral Fractures: An Alternative to Triangular Osteosynthesis

et al. 2018

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Study DesignBiomechanical study.PurposeTo investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum.Overview of LiteratureThe reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures.MethodsTo simulate a vertically unstable fractured sacrum, 12 synthetic pelvic models were prepared. In each model, a 5-mm gap was created through the left transforaminal zone (Denis zone II). The pubic symphysis was completely separated and then stabilized using a 3.5-mm reconstruction plate. Four each of the unstable pelvic models were then fixed with two iliosacral screws, a tension band plate, or a transiliac fixation plus one iliosacral screw. The left hemipelvis of these specimens was docked to a rigid base plate and loaded on an S1 endplate by using the Zwick Roell z010 material testing machine. Then, the vertical displacement and coronal tilt of the right hemipelves and the applied force were measured.ResultsThe transiliac fixation plus one iliosacral screw constructions could withstand a force at 5 mm of vertical displacement greater than the two iliosacral screw constructions (p=0.012) and the tension band plate constructions (p=0.003). The tension band plate constructions could withstand a force at 5° of coronal tilt less than the two iliosacral screw constructions (p=0.027) and the transiliac fixation plus one iliosacral screw constructions (p=0.049).ConclusionsThis study proposes the use of transiliac fixation in addition to an iliosacral screw to stabilize vertically unstable sacral fractures. Our biomechanical data demonstrated the superiority of adding transiliac fixation to withstand vertical displacement forces.

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“…The causes of the injury were motor vehicle accidents in 34 cases (46.5%), falls from a height in 17 cases (23.3%), occupational injuries in 13 cases (17.8%), motor versus pedestrian in 3 cases (4.1%), sports related injuries in 3 cases (4.1%), 2 cases after an airplane (1.4%) and a helicopter crash (1.4%), respectively, and one case was a war related injury (1.4%). Fractures of the transverse processes were seen in 34 cases (46.5%) [1, 2, 4-6, 8, 10, 12, 13, 15, 17, 18, 21, 23, 24, 28, 31, 37, 38-43, 47, 49, 50, 52], and disk involvement at L5-S1 level was present in 12 cases (16.4%) [1, 4, 10, 19, 28, 30, 32, 35, 45, 49]. The ratio bilateral/unilateral fracture-dislocations were 1.1:1.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Lumbosacral Dislocation: Case Report and a Comprehensive Review

Grivas¹,

Papadakis²,

Katsiva³

et al. 2012

TOORTHJ

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Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed.

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Traumatic Spondylopelvic Dissociation

Abstract: The unique fracture pattern described in this patient is presented to offer better insight into management of this complex injury and to delineate it from simpler patterns of injury to the lumbosacral junction.

Cited by 53 publications

References 21 publications

Spinopelvic Fixation Supplemented With Gullwing Plate for Multiplanar Sacral Fracture With Spinopelvic Dissociation: A Case Series With Short Term Follow Up

Spinopelvic Fixation Supplemented With Gullwing Plate for Multiplanar Sacral Fracture With Spinopelvic Dissociation: A Case Series With Short Term Follow Up

Biomechanical Study of Posterior Pelvic Fixations in Vertically Unstable Sacral Fractures: An Alternative to Triangular Osteosynthesis

Unilateral Lumbosacral Dislocation: Case Report and a Comprehensive Review

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