Lumbosacral dislocation injuries: management and outcomes

Lumbosacral dislocations are rare high-energy injuries most often reported as isolated cases. Improved outcomes from major trauma means that these cases will likely become more common. We report six cases treated at our institution in the last decade. Nonoperative care in two cases resulted in severe deformity and pain and required late reconstruction. Surgical decompression, reduction, and stabilization with posterior pedicle screw instrumentation resulted in a stable lumbosacral junction, although in one case, implant failure required revision with anterior column reconstruction to achieve that stability. Nerve root injuries recovered. Two cases had pre-existing spondylolysis/spondylolisthesis. Clinical results were very satisfactory if there was no pre-existing chronic low back pain, although overall function was determined by outcome from other injuries sustained at the initial trauma.