Traumatic spinopelvic dissociation: A case series.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Spinal Surgery

Background:

• Spinopelvic dissociation is a rare but severe injury, first described in 1969, involving the separation of the lumbar spine and sacrum.
• It accounts for approximately 2.9% of pelvic disruptions and is typically associated with high-energy trauma.

Purpose of the Study:

• To review and analyze a case series of spinopelvic dissociations treated at the institution.
• To evaluate the effectiveness of treatment and patient outcomes.

Main Methods:

• A retrospective study of nine patients with spinopelvic dissociation treated between May 2016 and December 2020.
• Analysis included demographic data, injury mechanisms, fracture classification (AO Spine Sacral Classification), neurological deficits (Gibbon's classification), and functional outcomes (Majeed score).

Main Results:

• Seven of nine patients were male, with injuries primarily caused by motor vehicle accidents (70%).
• Four patients experienced neurological deficits; one required ICU admission. All patients underwent spinopelvic fixation.
• Complications included surgical site infection (1), infected instruments with osteomyelitis (1), and focal neurological deficit (1). Six patients achieved healing and full neurological recovery.

Conclusions:

• Spinopelvic dissociation injuries are severe and linked to high-energy trauma.
• The triangular fixation method provides a stable construct for managing these complex injuries.