Displaced fracture of the lumbosacral spine with delayed cauda equina deficit: report of a case and review of literature.

A 41-year-old man with a fracture of the upper sacrum and forward and downward displacement of the superior sacral fragment and upper spine on the lower sacrum, developed partial deficit of cauda equina function. Similar fractures rarely have been reported. Signs of lumbar pain, contusion, and fractured transverse processes should lead the surgeon to carefully examine the radiologic fractures of the area of injury; otherwise, this lesion may heal unrecognized. With the spine in flexion, the fracture may create mechanical instability. Early closed or open reduction is theoretically ideal. Surgical treatment must be weighed in terms of the risks and needs of the individual.