Retrospective series of 18–19 patients with highly displaced, comminuted Denis Zone III sacral fracture-dislocations causing spino-pelvic dissociation, all treated with open reduction, sacral laminectomy, and lumbopelvic fixation at a level-1 trauma center. The study reports radiographic and neurological outcomes and tests which injury characteristics predict recovery of cauda equina function.
When you encounter a Denis Zone III sacral fracture with spino-pelvic dissociation and cauda equina deficit that is irreducible by closed means, lumbopelvic fixation (lumbar pedicle screws to iliac screws, bypassing the sacral fracture) is the construct of choice — it reliably achieves union and alignment.
Intraoperatively, document sacral root continuity: intact roots predict 86% complete neurological recovery, while any root discontinuity drops that to zero, and this finding should shape your prognostic counseling.
Retrospective series of 18–19 patients with highly displaced, comminuted Denis Zone III sacral fracture-dislocations causing spino-pelvic dissociation, all treated with open reduction, sacral laminectomy, and lumbopelvic fixation at a level-1 trauma center. The study reports radiographic and neurological outcomes and tests which injury characteristics predict recovery of cauda equina function.
When you encounter a Denis Zone III sacral fracture with spino-pelvic dissociation and cauda equina deficit that is irreducible by closed means, lumbopelvic fixation (lumbar pedicle screws to iliac screws, bypassing the sacral fracture) is the construct of choice — it reliably achieves union and alignment.
Intraoperatively, document sacral root continuity: intact roots predict 86% complete neurological recovery, while any root discontinuity drops that to zero, and this finding should shape your prognostic counseling.