The sacrum forms the distal end of the spine and communicates with the pelvis. Fractures involving the sacrum are complex and may disrupt this vital communication. Neglecting these fractures may result in malunion, which often causes significant alteration in the pelvic parameters and sagittal balance. Management of ensuing deformities is complex and poorly described. The authors present a case of sacral malunion with sagittal imbalance treated with a low lumbar osteotomy.
ABBREVIATIONSAP = anteroposterior; LL = lumbar lordosis; PI = pelvic incidence; PSO = pedicle subtraction osteotomy; PT = pelvic tilt; SS = sacral slope; SVA = sagittal vertical axis.
Correspondence Tarush Rustagi: Swedish Neurosciences Institute, Seattle, WA. firstname.lastname@example.org.
INCLUDE WHEN CITING Published online March 29, 2019; DOI: 10.3171/2019.1.SPINE181271.
V.S. and T.R. contributed equally to this work.
Disclosures Dr. Hart has the following disclosures. Honoraria, consultation, and royalties: Globus, Seaspine, DePuy Synthes, Medtronic, Orthofix. The International Spine Study Group Foundation (ISSGF) provides study funding for other projects.
Duval-BeaupèreG, SchmidtC, CossonP: A Barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. 20:451–462, 1992151029610.1007/BF02368136)| false
JacksonRPPetersonMDMcManusACHalesC: Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine (Phila Pa 1976)23:1750–17671998
JacksonRP, PetersonMD, McManusAC, HalesC: Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. 23:1750–1767, 1998972837610.1097/00007632-199808150-00008)| false
RosePSBridwellKHLenkeLGCronenGAMulconreyDSBuchowskiJM: Role of pelvic incidence, thoracic kyphosis, and patient factors on sagittal plane correction following pedicle subtraction osteotomy. Spine (Phila Pa 1976)34:785–7912009