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Sacral Insufficiency Fracture Surgery Complication

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Abstract

Sacral insufficiency fractures are a relatively uncommon complication following lumbosacral instrumented arthrodesis. Risk factors for developing an insufficiency fracture include osteopenia/osteoporosis, increased body mass index, an increased pelvic incidence (PI), and deformity correction and may additionally include surgical technique. Correctly diagnosing an insufficiency fracture can be challenging and requires a high index of suspicion. Diagnosis may be facilitated by lumbosacral computerized tomographic (CT) imaging with coronal reconstructions, as the fracture may be difficult to visualize with axial and sagittal sequences alone. In this chapter, we discuss a case of a postoperative sacral insufficiency fracture, the subsequent surgical treatment of this complication, and recommendations for complication avoidance.

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References

  1. Bose B. Fracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature. J Neurosurg. 2003;99(3 Suppl):310–2.

    PubMed  Google Scholar 

  2. Klineberg E, McHenry T, Bellabarba C, Wagner T, Chapman J. Sacral insufficiency fractures caudal to instrumented posterior lumbosacral arthrodesis. Spine. 2008;33(16):1806–11.

    Article  PubMed  Google Scholar 

  3. Wilde GE, Miller TT, Schneider R, Girardi FP. Sacral fractures after lumbosacral fusion: a characteristic fracture pattern. AJR Am J Roentgenol. 2011;197(1):184–8.

    Article  PubMed  Google Scholar 

  4. Lyders EM, Whitlow CT, Baker MD, Morris PP. Imaging and treatment of sacral insufficiency fractures. AJNR Am J Neuroradiol. 2010;31(2):201–10.

    Article  CAS  PubMed  Google Scholar 

  5. Wood KB, Schendel MJ, Ogilvie JW, Braun J, Major MC, Malcom JR. Effect of sacral and iliac instrumentation on strains in the pelvis. A biomechanical study. Spine. 1996;21(10):1185–91.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University of Virginia, PO Box 800212, Charlottesville, VA, 22908, USA

    Michael LaBagnara, Durga R. Sure, Christopher I. Shaffrey & Justin S. Smith

  2. Department of Neurosurgery, Essentia Health Duluth, Duluth, MN, USA

    Durga R. Sure

Authors
  1. Michael LaBagnara
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  2. Durga R. Sure
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  3. Christopher I. Shaffrey
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  4. Justin S. Smith
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Corresponding author

Correspondence to Justin S. Smith .

Editor information

Editors and Affiliations

  1. Joan O’Reilly Endowed Professor in Spinal Surgery, Vice Chairman, Department of Neurosurgery, University of California, San Francisco, California, USA

    Praveen V. Mummaneni

  2. Professor, Director of Spinal Surgery, Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA

    Paul Park

  3. University of Louisville, Norton Leatherman Spine Center, Louisville, Kentucky, USA

    Charles H. Crawford III

  4. Chief, Division of Spine Surgery, Associate Professor of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Adam S. Kanter

  5. Department of Orthopedic Surgery, University of Louisville, Norton Leatherman Spine Center, Louisville, Kentucky, USA

    Steven D. Glassman

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LaBagnara, M., Sure, D.R., Shaffrey, C.I., Smith, J.S. (2018). Sacral Insufficiency Fracture Surgery Complication. In: Mummaneni, P., Park, P., Crawford III, C., Kanter, A., Glassman, S. (eds) Spinal Deformity . Springer, Cham. https://doi.org/10.1007/978-3-319-60083-3_34

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  • DOI: https://doi.org/10.1007/978-3-319-60083-3_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60082-6

  • Online ISBN: 978-3-319-60083-3

  • eBook Packages: MedicineMedicine (R0)

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