E-Case report

Sacral Fracture H-type, C3Stefan Lauinger, MD

Pre OP

Clinical Case – Sacral Fracture
H-type, C3

Stefan Lauinger, MD
Orthopaedic & Trauma surgeon
Klinik für Unfallchirurgie und Orthopädie
Klinium Itzehoe
Itzehoe, Germany

Patient Information

 

This female patient, 73yo, BMI 22.5 (154cm, 55kg) suffered a sacral fracture (H-type, C3) after a fall from the rim of the bathtub.

She was treated by a general practitioner with pain medication. 19 days later treated in outpatient department without a correct diagnosis. After another 3 days she was admitted to hospital due to increasing pain (VAS 8).

Indication: Sacral fracture with spinopelvic instability

Other pathological conditions: Zn # of 3 vertebrae

Comorbidities: Art HT, osteoporotic bone quality (medication)

Risk factor: ASA 2

The patient had experienced no previous orthopaedic/spine surgery

Pre OP radiographs,
frontal and sagittal views

Pre OP CTs in different planes confirm the sacral fractures

Pre OP MRI stir sequence

The surgery was planned for spinopelvic stabilization of levels L5 – Ilium to be fused.

General anesthesia ITN.

Mini-open access spina iliaca post to L5 on both sides.

Intra OP

Surgical Procedure

The surgery was planned for spinopelvic stabilization of levels L5 – Ilium to be fused.

General anesthesia ITN.

Mini-open access spina iliaca post to L5 on both sides.

Neo Pedicle Screw System™ was used for the posterior construct includingiliac connector.

Ilium: 2 x Iliac screws Ø8.0 x 100mm, polyaxial

Level L5: 2 x Ø8.0 x 50mm

Iliac connectors, 40mm and 70mm (shortened by about 15mm), parallel connectors

2 x 60mm titanium pre-bent rods to achieve a force control fixation.

Post OP

Post OP result

  • Intraoperative blood loss: 200ml
  • Duration of surgery was 72 minutes
  • No complications occurred postoperatively
  • Hospital stay was 15 days, the prolonged hospital stay was due to a challenging situation at home with stairs and steps
  • Rehab in outpatient clinic
  • Post OP pain score (VAS):
    • Back pain: 3
    • Leg pain: 0
  • Intact neurological status

Post OP Radiographs,
frontal and sagittal views

Published with the approval of Dr. Stefan Lauinger, MD