Outcomes of Operative Management of Traumatic Transverse Sacral Fractures; Systematic Review and Meta-Analysis

Abstract

he sacrum is a keystone structure that is important to the structural integrity of the base of the spinal column and posterior pelvic ring. Therefore, depending on the fracture pattern, fracture of the sacrum may have implications on posterior pelvic or spinopelvic stability. Sacral fracture classifications are based on fracture location, pattern of instability, and risk of neurologic deficits. Sacral fractures have emerged from relatively underappreciated entities to injuries whose optimal treatment is recognized to have profound consequences on the patient’s functional outcome. Advances in diagnostic imaging continue to provide additional insights into the structural and neurologic aspects of the injured sacrum, allowing comprehensive injury assessment even in the cognitively impaired and poly-traumatized patient. In cases of neurologic deficit, excessive mal-alignment or instability, surgical intervention involves neurologic decompression, fracture realignment, and surgical fixation in order to optimize long-term outcomes. The timing of surgical intervention is determined by several factors, including the patient’s associated injuries, overall physiologic condition, and the presence of neurologic