Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
JBJS Case Connect. 2023 Nov 2;13(4). doi: 10.2106/JBJS.CC.23.00350. eCollection 2023 Oct 1.
We present a case of a 54-year-old man with atraumatic, U-type sacral insufficiency and L5 compression fractures leading to spinopelvic dissociation, inability to ambulate, and bowel/bladder compromise. The patient underwent L3-4 percutaneous pedicle screw fixation with bilateral iliac bolts and percutaneous iliosacral screw fixation. Postoperatively, the patient had return of bowel/bladder function and independent ambulation at 2.5 years.
Atraumatic spinopelvic dissociation is an underappreciated pathology in older patients. Here, we describe the result of our preferred treatment strategy, triangular osteosynthesis, to preserve function and independence. Despite optimal, prompt treatment, these injuries pose a difficult rehabilitation process for patients.
我们报告一例 54 岁男性，无创伤性 U 型骶骨不稳定性，L5 压缩性骨折导致脊柱骨盆分离，无法行走，伴有肠/膀胱功能障碍。患者接受 L3-4 经皮椎弓根螺钉固定，双侧髂骨螺钉和经皮骶髂螺钉固定。术后 2.5 年，患者肠/膀胱功能恢复，可独立行走。
无创伤性脊柱骨盆分离在老年患者中被低估。在此，我们描述了我们首选的治疗策略——三角骨合成术，以保留功能和独立性的结果。尽管进行了最佳、及时的治疗，但这些损伤对患者的康复过程构成了很大的挑战。
