Outcomes of lumbopelvic fixation in the treatment of complex sacral fractures using minimally invasive surgical techniques

Jazini, Ehsan; Weir, Tristan; Nwodim, Emeka; Tannous, Oliver; Saifi, Comron; Caffes, Nicholas; Costales, Timothy; Koh, Eugene Y.; Banagan, Kelley; Gelb, Daniel E.; Ludwig, Steven C.

doi:10.1016/j.spinee.2017.04.032

Cited by 29 publications

(28 citation statements)

References 22 publications

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“…A recent paper reviewed 521 traumatic transverse sacral fracture patients and concluded there was no improved neurological recovery after surgical treatment compared with nonoperative treatment [28]. As this kind of injury is often associated with spinopelvic dislocation, lumboiliac fixation for transverse sacral fractures has been increasingly used to reconstruct lumbosacral stability in recent years [5–10,12,29,30]. Because indirect decompression can be achieved through realignment of displaced fractures, there is debate about whether direct decompression is needed.…”

Section: Discussionmentioning

confidence: 99%

Isolated Decompression for Transverse Sacral Fractures with Cauda Equina Syndrome

Qiu

Shi

et al. 2019

Med Sci Monit

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Background The purpose of this study was to evaluate the clinical outcomes of isolated decompression for patients with transverse sacral fractures and cauda equina syndrome, which have been rarely reported before. Material/Methods Twelve neurological impaired patients with transverse sacral fracture from January 2010 to March 2017 treated in our institution were evaluated. All patients went through isolated decompression and were followed for a minimum of 12 months. Fracture causes, classifications, associated injury, radiologic results, clinical outcomes using the Majeed index, and neurological outcomes using the Gibbons criteria were evaluated. Results Motor vehicle accidents and falling injuries were the major causes of trauma. The average time from trauma to surgery was 89.8 days. Eleven patients underwent laminectomy with no more than 3 segments resected and 1 patient had S1-S4 excised. Three patients with fracture involving the lumbopelvic joint had L5 laminectomy. All patients achieved bony union, with 7 patients (63.6%) showing satisfactory pelvic outcome. Average Gibbons scores improved from 2.8 to 1.9 at 18-month average follow-up, but most patients were left with residual pain. No surgical-related complications were seen in any patients. Conclusions Isolated decompression can be considered for patients who present a stable sacrum with non-displaced fracture or an old fracture that shows fracture healing. Favorable pelvic outcomes and neurological recovery, along with acceptable stability, can be acquired.

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Section: Discussionmentioning

confidence: 99%

Isolated Decompression for Transverse Sacral Fractures with Cauda Equina Syndrome

Qiu

Shi

et al. 2019

Med Sci Monit

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“…n/a n/a n/a n/a n/a Mean n/a n/a n/a n/a n/a n/a n/a 21.7 mo (14-32) n/a n/a n/a n/a n/a n/a Ayoub (2012)/Eur Spine J 18 26 mo n/a n/a n/a n/a Excellent: 28 14 mo (8-26) n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Lindahl et al (2014)/ Injury 19 33 mo (18-71) n/a n/a n/a n/a n/a n/a Williams et al (2016)/J Orthop Trauma 31 21 mo n/a n/a n/a n/a n/a 33 12 mo n/a n/a n/a n/a n/a n/a Piltz et al (2017)/Eur Spine J 34 47, 33, 29 mo n/a n/a n/a n/a n/a n/a Jazini et al (2017)/ The Spine Journal 35 18.8 mo (0.4-64) n/a n/a n/a n/a n/a n/a 10 . By comparison, our results found higher scores over almost all sub-scores, suggesting a higher impairment.…”

Section: Bellabarba Et Al (2006)/spinementioning

confidence: 99%

Functional outcome of traumatic spinopelvic instabilities treated with lumbopelvic fixation

Yılmaz

Hoffmann

Glinski

et al. 2020

Sci Rep

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The aim of this study was to assess the functional outcome after lumbopelvic fixation (LPF) using the SMFA (short musculoskeletal functional assessment) score and discuss the results in the context of the existing literature. The last consecutive 50 patients who underwent a LPF from January 1st 2011 to December 31st 2014 were identified and administered the SMFA-questionnaire. Inclusion criteria were: (1) patient underwent LPF at our institution, (2) complete medical records, (3) minimum follow-up of 12 months. Out of the 50 recipients, 22 questionnaires were returned. Five questionnaires were incomplete and therefore seventeen were included for analysis. The mean age was 60.3 years (32–86 years; 9m/8f) and the follow-up averaged 26.9 months (14–48 months). Six patients (35.3%) suffered from a low-energy trauma and 11 patients (64.7%) suffered a high-energy trauma. Patients in the low-energy group were significantly older compared to patients in the high-energy group (72.2 vs. 53.8 years; p = 0.030). Five patients (29.4%) suffered from multiple injuries. Compared to patients with low-energy trauma, patients suffering from high-energy trauma showed significantly lower scores in “daily activities” (89.6 vs. 57.1; p = 0.031), “mobility” (84.7 vs. 45.5; p = 0.015) and “function” (74.9 vs. 43.4; p = 0.020). Our results suggest that patients with older age and those with concomitant injuries show a greater impairment according to the SMFA score. Even though mostly favorable functional outcomes were reported throughout the literature, patients still show some level of impairment and do not reach normative data at final follow-up.

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“…Der Vorteil gedeckter Techniken liegt auf der Hand. Neben einem geringeren perioperativen Weichteiltrauma werden insbesondere die bei offenen dorsalen Stabilisierungen beschriebenen, teils inakzeptabel hohen infektbedingten Komplikationsraten von 9 % [13] bis zu 21 % [14] beim gedeckten Vorgehen nicht mehr gesehen [15]. Nachteilig bleiben allerdings unverändert die nur eingeschränkten Möglichkeiten der geschlossenen Reposition [15].…”

Section: Wahl Von Zugang Und Osteosynthese -Trend Zu Minimal-invasiveunclassified

“…Neben einem geringeren perioperativen Weichteiltrauma werden insbesondere die bei offenen dorsalen Stabilisierungen beschriebenen, teils inakzeptabel hohen infektbedingten Komplikationsraten von 9 % [13] bis zu 21 % [14] beim gedeckten Vorgehen nicht mehr gesehen [15]. Nachteilig bleiben allerdings unverändert die nur eingeschränkten Möglichkeiten der geschlossenen Reposition [15]. Nichtsdestotrotz weist ein Großteil versorgungspflichtiger Instabilitäten vom Typ B (höhergradig) oder C primär entweder keine wesentliche Dislokation im Bereich des hinteren Beckenrings auf oder erlaubt über indirekte Repositionstechniken, z.…”

Section: Wahl Von Zugang Und Osteosynthese -Trend Zu Minimal-invasiveunclassified

Versorgung instabiler Verletzungen des hinteren Beckenringes – bewährte Methoden und neue Konzepte

Mendel

Heinecke

Klauke

et al. 2018

Trauma Berufskrankh

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Outcomes of lumbopelvic fixation in the treatment of complex sacral fractures using minimally invasive surgical techniques

Cited by 29 publications

References 22 publications

Isolated Decompression for Transverse Sacral Fractures with Cauda Equina Syndrome

Isolated Decompression for Transverse Sacral Fractures with Cauda Equina Syndrome

Functional outcome of traumatic spinopelvic instabilities treated with lumbopelvic fixation

Versorgung instabiler Verletzungen des hinteren Beckenringes – bewährte Methoden und neue Konzepte

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