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Related Experiment Videos

Lumbosacral plexopathy in pelvic trauma.

R L Kutsy1, L R Robinson, M L Routt

  • 1Department of Neurology, University of Washington, Harborview Medical Center, Seattle, Washington, USA.

Muscle & Nerve
|October 31, 2000
PubMed
Summary

Pelvic trauma can cause lumbosacral plexopathy, particularly with sacral fractures. Electromyography (EMG) revealed a higher incidence in patients with sacral injuries compared to other pelvic fractures.

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Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Electrophysiology

Background:

  • Pelvic trauma is a significant cause of injury to the nervous system.
  • Lumbosacral plexopathy can result from various types of pelvic fractures.
  • Understanding the specific fracture patterns associated with plexopathy is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the electrophysiologic findings and causes of lumbosacral plexopathy in patients with pelvic trauma.
  • To determine the incidence of lumbosacral plexopathy in relation to different types of pelvic fractures.
  • To differentiate between direct plexus injury and peripheral nerve injury in acetabular and femoral fractures.

Main Methods:

  • Review of electrophysiologic data from electromyography (EMG) in 22 patients with pelvic trauma.
  • Analysis of fracture types, including sacral, sacroiliac joint, acetabular, and femoral fractures.
  • Correlation of fracture patterns with the diagnosis of lumbosacral plexopathy.
  • Utilized magnetic resonance imaging (MRI) neurogram in select cases for further clarification.

Main Results:

  • Lumbosacral plexopathy was diagnosed in patients with pelvic trauma.
  • Sacral fractures or sacroiliac joint separation were present in 68% of patients.
  • A significantly higher incidence of lumbosacral plexopathy (2.03%) was observed in patients with sacral fractures compared to the overall population (0.7%).

Conclusions:

  • Sacral fractures are a significant risk factor for developing lumbosacral plexopathy following pelvic trauma.
  • Patients with acetabular and femoral fractures may experience injuries to individual proximal nerves rather than the entire lumbosacral plexus.
  • Electromyography (EMG) and advanced imaging like MRI neurography are valuable tools in diagnosing and characterizing these injuries.

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