Lumbosacral plexus avulsion with pelvic fractures

Sidhu, J; Dhillon, M K

doi:10.1016/0020-1383(91)90084-r

Cited by 13 publications

(3 citation statements)

References 2 publications

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“…9 10) Root avulsion is less common and usually seen with more severe pelvic and sacral fractures. 11 12 13) sacroiliac fracture and/or dislocation associated with an L5 transverse process fracture may also result in an L5 nerve root tractioninjury. 14) …”

Section: Discussionmentioning

confidence: 99%

Value of Direct Decompression of Lumbosacral Roots in Sacral Fractures with Neurologic Deficit: Is It Mandatory?

Elsherif¹,

Mokhtar²

2023

Clin Orthop Surg

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Background The value of direct decompression of neural structures to treat lumbosacral plexus injury associated with sacral fractures is still debatable. Direct decompression allows decompression of nerve roots by sacral laminectomy and removal of bone fragments in the spinal canal. In contrast, indirect decompression may offer similar neurological outcomes if good fracture reduction and correction of sacral kyphosis are achieved. In this comparative retrospective study, we analyzed differences between direct and indirect neurological decompression in terms of neurological recovery, complications, and functional outcome. Methods This study included 33 cases with spinopelvic dissociation with variable degrees of lumbosacral plexus injury. All cases were managed by spinopelvic fixation. Eighteen patients (group 1) had direct decompression of lumbosacral nerve roots while 15 patients (group 2) had indirect decompression. Results Initial sacral kyphosis, quality of fracture reduction, and postoperative residual kyphosis were the main factors that significantly affected functional and neurological outcome in both groups. The final neurological improvement was similar in both groups. No significant difference was observed between both groups in the residual Gibbons’ score recorded in the last visit ( p = 0.206). The final Majeed score also showed no significant difference between the two groups ( p = 0.869). Conclusions Indirect decompression of sacral fractures showed similar final functional outcome and neurological recovery compared to direct decompression. Restoration of lumbosacropelvic stability and anatomic reduction seem to be the cornerstone for better functional outcome and neurological recovery rather than direct decompression of neural elements.

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Section: Discussionmentioning

confidence: 99%

Value of Direct Decompression of Lumbosacral Roots in Sacral Fractures with Neurologic Deficit: Is It Mandatory?

Elsherif¹,

Mokhtar²

2023

Clin Orthop Surg

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“…2,4 Nerve root avulsion also has been reported. 1,2,[11][12][13] Myelography is useful for evaluating a pseudomeningocele or diverticulum-like outpouching. 5 Recently, MRI has been used to diagnosis nerve root avulsion related to pelvic injury.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Lumbosacral Plexus Palsy Related to Pelvic Fracture

Sugimoto¹,

Ito²,

Tomioka³

et al. 2010

Spine

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“…The first clear description of a lumbosacral plexus injury came only approximately 50 years ago [ 33 ]. Opposing to the brachial plexus, the lumbosacral plexus has the supportive strength of the bony pelvis, which protects the nerve roots against excessive stretching and rupture [ 34 ]. In the brachial plexus injuries, the main mechanism is direct trauma, while in the lumbosacral plexus it is indirect traumas (Figures 4 and 5 ), as well as spinal-related injuries, hip dislocations and fractures, inguinal hernia, aortic aneurysms, and lesions affecting psoas muscle (such as hematomas and abscesses).…”

Section: Pathologiesmentioning

confidence: 99%

Demystifying MR Neurography of the Lumbosacral Plexus: From Protocols to Pathologies

Neto

Filho

Miranda

et al. 2018

BioMed Research International

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Magnetic resonance neurography is a high-resolution imaging technique that allows evaluating different neurological pathologies in correlation to clinical and the electrophysiological data. The aim of this article is to present a review on the anatomy of the lumbosacral plexus nerves, along with imaging protocols, interpretation pitfalls, and most common pathologies that should be recognized by the radiologist: traumatic, iatrogenic, entrapment, tumoral, infectious, and inflammatory conditions. An extensive series of clinical and imaging cases is presented to illustrate key-points throughout the article.

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Lumbosacral plexus avulsion with pelvic fractures

Cited by 13 publications

References 2 publications

Value of Direct Decompression of Lumbosacral Roots in Sacral Fractures with Neurologic Deficit: Is It Mandatory?

Value of Direct Decompression of Lumbosacral Roots in Sacral Fractures with Neurologic Deficit: Is It Mandatory?

Risk Factors for Lumbosacral Plexus Palsy Related to Pelvic Fracture

Demystifying MR Neurography of the Lumbosacral Plexus: From Protocols to Pathologies

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