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Updated: May 8, 2026

Intraoperative Ultrasound in Spinal Surgery

Intraoperative Ultrasound in Spinal Surgery

Published on: August 17, 2022

Complex sacral fracture.

José Luís Alves¹, Nubélio Duarte, Armando Rocha

¹Department of Neurosurgery, Hospital Center and University of Coimbra, Coimbra, Portugal. jlmonteiroalves@gmail.com

BMJ Case Reports

|September 5, 2013

Summary

Cauda equina syndrome from sacral fractures can be challenging to diagnose early. Conservative management, alongside close monitoring, can lead to significant recovery, suggesting surgery isn't always necessary.

Area of Science:

Orthopedics
Neurosurgery
Physical Medicine and Rehabilitation

Background:

Sacral fractures can cause cauda equina syndrome, presenting diagnostic and therapeutic challenges.
Early diagnosis and management are crucial for optimal patient outcomes.

Observation:

A case of cauda equina syndrome secondary to sacral fracture following a fall is presented.
The patient experienced significant improvement with conservative management and close follow-up.

Findings:

Early diagnosis of complex sacral fractures is difficult, with a need for low threshold for imaging (CT/MRI) when neurological compromise is suspected.
A multidisciplinary approach involving orthopedics, neurosurgery, and physiatry is recommended.
Conservative management can be effective, challenging the notion that surgical decompression is the sole valid option.

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Implications:

This case highlights the importance of thorough clinical examination and timely imaging for sacral fractures with neurological deficits.
Conservative treatment may be a viable alternative to surgery in selected cases.
Further prospective studies are needed to refine patient selection and intervention timing for sacral fractures causing cauda equina syndrome.