title: Transsacral-Transiliac Screw Stabilization: Effective for Recalcitrant Pain Due to Sacral Insufficiency Fracture.
abstract: OBJECTIVE
  To evaluate the effectiveness of transsacral-transiliac screw fixation for the treatment of sacral insufficiency fractures that fail nonoperative treatment.
  
  
  METHODS
  A pilot study series of consecutive patients identified over 5 years were treated and followed prospectively.
  
  
  METHODS
  Academic-affiliated, tertiary referral, level 1 trauma center in Dallas, TX.
  
  
  METHODS
  Patients were selected on the basis of presenting diagnosis, and failure of nonoperative treatment of their sacral insufficiency fracture. Eleven patients entered to the study, and 10 completed follow-up.
  
  
  METHODS
  Placement of transsacral-transiliac screws for sacral insufficiency fracture.
  
  
  METHODS
  Comparison of preoperative and postoperative Visual Analog Scale scores and Oswestry Low Back Disability Index scores.
  
  
  RESULTS
  Patients experienced statistically significant improvement in both outcome measures after intervention. No complications encountered.
  
  
  CONCLUSIONS
  Transsacral-transiliac screw fixation seems to be a safe and effective treatment for sacral insufficiency fractures recalcitrant to nonoperative management.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX; and†Orthopaedic Trauma Service, Tampa, FL.
authors.forename: Drew
authors.initials: D
authors.lastname: Sanders
authors.forename: Joshua
authors.initials: J
authors.lastname: Fox
authors.forename: Adam
authors.initials: A
authors.lastname: Starr
authors.forename: Ashoke
authors.initials: A
authors.lastname: Sathy
authors.forename: John
authors.initials: J
authors.lastname: Chao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D015775:Fractures, Stress / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000601:surgery; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D012447:Sacrum / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation; D016896:Treatment Outcome