Management of lumbosacropelvic fracture-dislocation using lumbo-iliac internal fixation

Traumatic lumbosacropelvic fracture-dislocation is a rare but potentially serious injury. Conventional methods like lumbosacral fixation used to treat such injuries often result in suboptimal outcome secondary to complications like pseudoarthroses, sagittal imbalance and hardware failure. In this study, we retrospectively analysed the clinical features and management for this trauma using lumbo-iliac fixation.

Eight patients (6 male, 2 female; 21-52 years old, mean: 38.4) with traumatic lumbosacropelvic fracture-dislocation were surgically managed by lumbo-iliac internal fixation after lumbosacral decompression. Patients were followed up for 24-40 months (mean: 31.6). American Spine Injury Association (ASIA) scores were measured before surgery and at the last follow-up, and statistically analysed.

After surgery, all patients experienced improved sensory and motor performance. Six patients showed recovery of bowel and bladder functions. Immediately after lumbo-iliac fixation, all patients could turn in bed without assistance. Lumbosacral alignment was restored immediately after surgery and no dislocation was observed during follow-up. Radiography indicated excellent integration between the autograft and the vertebrae. After surgery, no patient experienced neurological deterioration.

Our experience with these cases suggests that early surgical decompression and posterior lumbo-iliac internal fixation can effectively restore spinal alignment, stabilise the spine, and improve neurological symptoms for this complex trauma.