Turkish Neurosurgery 2014 , Vol 24 , Num 4
Surgical Treatment in Sacral Fractures and Traumatic Spinopelvic Instabilities
Sedat DALBAYRAK1, Onur YAMAN2, Murat AYTEN1, Mesut YILMAZ1, Ali Fahir OZER3
1Neurospinal Academy, Department of Neurosurgery, Istanbul, Turkey
2Tepecik Education and Research Hospital, Department of Neurosurgery, Izmir, Turkey
3Koc University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.8980-13.0 AIM: Sacral fractures are generally seen together with pelvic ring fractures. They can also develop in isolated form rarely. Instability is observed in these fractures in rates reaching 30%.

MATERIAL and METHODS: Spinopelvic stabilization was applied to 10 cases with pelvic fractures together with sacral fractures and spinopelvic instability. Two cases were treated with adductive screws extending from the iliac wing to the sacrum, 5 cases with standard lumboiliac instruments and 3 cases were treated with iliac wing plates that are our own design. The cases were evaluated according demographic data, VAS, ASIA and Oswestry scores and the types of the trauma and fracture.

RESULTS: Six cases had unilateral sacroiliac instability while the instability was bilateral in 4 cases. Follow-up periods range between 6 and 91 months. Preoperative VAS was 8.4, Oswestry mean value was 91.2, postoperative late VAS was 2.2, and Oswestry was 24.4.

CONCLUSION: Serious spinopelvic instability can be talked of in sacral fractures accompanied by pelvic fractures, particularly when the anterior and posterior integrity of the pelvic ring is interrupted together. An aggressive stabilization and fixation must be performed without delay. Keywords : Sacral fracture, Spinopelvic instability, Pelvic fracture, Iliac plates

Corresponding author : Onur Yaman, dronuryaman@yahoo.com