Effect of the sacral canal decompression combined with lumbar-pelvic fixation in the treatment of traumatic sacral fractures complicated with spine-pelvic separation

ObjectiveTo investigate the effects of the sacral canal decompression combined with lumbar-pelvic fixation in the treatment of traumatic sacral fractures complicated with spine-pelvic separation.

MethodsSixteen patients with traumatic sacral fractures(Denis type Ⅲ) complicated with spine-pelvic separation were treated with sacral canal decompression combined with lumbar-pelvic fixation, and followed up for more than 2 years.The relative indexes of patients before and after the operation were recorded.The neurological Gibbons scores of patients were compared between before operation and last follow-up.The comprehensive efficacy was evaluated according to the Majeed functional score, and the complication was recorded.

ResultsThe operations of all patients were successfully completed.The time of operation, blood loss, hospital stay and time of fracture healing of patients were (172.34±43.23)min, (670.98±98.34)mL, (25.76±6.45)d and (4.21±0.43) months, respectively.Compared with before operation, the last follow-up Gibbons score and Majeed score of patients significantly decreased and increased, respectively(P < 0.01).The results of the last follow-up showed the excellent in 7 cases, good in 4cases, fair in 4 cases and poor in 1 case, and the good rate of which was 68.75%.The postoperative incision infection in 2 cases, hemorrhoids in 1 case, and no serious complications, such as steel plate, connecting rod fracture, fracture and displacement, were found.

ConclusionsThe sacral canal decompression combined with lumbar-pelvic fixation can reconstruct the pelvic ring and spinal stability, and improve the postoperative neurological function and activity in patients with traumatic sacral fractures complicated with spine-pelvic separation.