Is Sacral Dysmorphism Protective Against Spinopelvic Dissociation? Multicenter Case Series.

Area of Science:

• Orthopedic Surgery
• Trauma Radiology
• Anatomical Studies

Background:

• Spinopelvic dissociation (SPD) involves severe injuries to the pelvis and sacrum.
• Sacral dysmorphism (SD) refers to variations in sacral bone anatomy.
• The relationship between SD and SPD requires further investigation.

Purpose of the Study:

• To determine the incidence of sacral dysmorphism (SD) in patients diagnosed with spinopelvic dissociation (SPD).
• To analyze fracture patterns and deformities in patients with and without SD.

Main Methods:

• Retrospective case series analysis of 1850 adult patients with sacral and pelvic fractures.
• Inclusion criteria: OTA/AO 61-A, B, C fractures.
• Radiographic review using plain pelvic radiographs and CT scans.

Main Results:

• Eighty-two patients with SPD were identified, with 12.2% exhibiting SD.
• S2 sacral body fractures were most common in both SD and non-dysmorphic (ND) groups.
• Roy-Camille type II patterns were more prevalent in the SD group (40%) compared to the ND group (35%).
• SD patients had lower BMIs (19.7 vs. 25.2).

Conclusions:

• The prevalence of SD in SPD is lower than previously reported.
• Variations in sacral anatomy may influence force transmission and protect against certain high-energy fractures.
• Preoperative assessment of sacral anatomy is vital for surgical planning and understanding trauma pathomechanics.