Surgical treatment of sacral fractures following lumbosacral arthrodesis: Case report and literature review
Surgical treatment of sacral fractures following lumbosacral arthrodesis: Case report and literature review作者机构：Department of Orthopaedics Peking University First Hospital
出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)
年 卷 期：2016年第7卷第1期
页 面：69-73页
学科分类：0403[教育学-体育学] 1002[医学-临床医学] 10[医学]
主 题：Sacral fracture Insufficiency fracture Surgical treatment Complication Lumbosacral fusion Revision surgery
摘 要：Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion in a 65-yearold patient with a 15-year history of corticosteroid use who underwent open reduction and internal fixation using iliac screws. The patient was followed for 2 years. A thorough review of the literature was conducted using the Medline database between 1994 and 2014. Immediately after the revision surgery, the patient s pain in the buttock and left leg resolved significantly. The patient was followed for 2 years. The weakness in the left lower extremity improved gradually from 3/5 to 5/5. In conclusion, the incidence of postoperative sacral fractures could have been underestimated, because most of these fractures are not visible on a plain radiograph. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion.
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