title: Modified lumbopelvic fixation for sacral and L5 fractures associated with spinopelvic instability: a case report and introduction of the surgical technique.
abstract: Posterior lumbopelvic fixation with iliac screws is the most commonly used method for unstable spinopelvic injuries. It has certain limitations including inability to use distraction along the spinopelvic rod as an indirect reduction maneuver, need for complex 3-dimensional rod contouring and complications such as hardware prominence and soft tissue coverage. In the present case report, we described a surgical technique of lumbopelvic fixation with sacral alar screws for traumatic spinopelvic instability resulted from a unilateral Denis-III comminuted sacral fracture and the L5 burst fracture. On the opposite side of the sacral fracture, caudal screws were implanted into the pedicle of the S1, whereas on the side of sacral fracture, two sacral alar screws were placed parallel to the superior sacral endplate as well as the plane of sacroiliac joint. In addition, horizontal stabilization was conducted with cross-link connections to maintain the longitudinal traction. For sacral fracture associated with traumatic spinopelvic instability, this modified lumbopelvic fixation technique using sacral alar screws makes longitudinal reduction easier, requires less rod contouring, and reduces hardware prominence without compromising the stability.
authors: Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science of Technology, Wuhan 430030, China.
authors: Cheng-la
authors: CL
authors: Yi
authors: Xiang-Jun
authors: XJ
authors: Bai
authors: Xian-Zhou
authors: XZ
authors: Song
authors: Zhan-Fei
authors: ZF
authors: Li
authors: Dan
authors: D
authors: Hu
mesh_terms: D001863:Bone Screws; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery; D018460:Fractures, Comminuted; D006801:Humans; D012447:Sacrum / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery