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Contralateral Back Pain Following Trans-sacral Trans-iliac Screw Fixation: Resolution After Hardware Removal.

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|January 23, 2026
PubMed
Summary
This summary is machine-generated.

A trans-sacral trans-iliac (TSTI) screw used for pelvic ring fracture fixation can cause long-term contralateral pain. Hardware removal resolved symptoms, suggesting TSTI screw placement requires careful consideration to avoid SI joint complications.

Keywords:
fixationpainpelvissacroiliac jointscrewtrans-sacral trans-iliac

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Pelvic Fractures

Background:

  • Pelvic ring fractures are severe injuries often requiring surgical intervention.
  • Trans-sacral trans-iliac (TSTI) screws are utilized for stabilizing pelvic ring fractures.
  • Long-term complications of TSTI fixation are not extensively documented.

Purpose of the Study:

  • To report a case of chronic contralateral pain following TSTI screw fixation for a pelvic ring fracture.
  • To discuss a potential long-term complication associated with TSTI screw placement.
  • To inform surgical decision-making regarding TSTI fixation.

Main Methods:

  • A case report of a 16-year-old female with a pelvic ring fracture (LC-2) treated with TSTI screw fixation.
  • Documentation of initial recovery and subsequent development of chronic contralateral pain 4 years post-surgery.
  • Surgical hardware removal and assessment of symptom resolution.

Main Results:

  • The patient initially recovered from the pelvic ring fracture repair.
  • Four years after TSTI fixation, the patient developed chronic right-sided back pain.
  • Following hardware removal, the patient remained symptom-free for 1 year.

Conclusions:

  • Penetration of the contralateral sacroiliac (SI) joint by a TSTI screw may lead to long-term contralateral pain.
  • This case highlights a potential, albeit rare, complication of TSTI fixation.
  • Surgeons should carefully consider TSTI screw placement to mitigate risks of SI joint-related morbidity.