Sacral Fractures Treatment: Systematic Review and Meta-Analysis

Abstract

Abstract Background The 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. Objective To review the literature about sacral fractures and to provide cumulative data about the outcome of different surgical modalities in management of sacral fractures. Patients and Methods This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Results We found 176 record; of them 82 unique records identified (duplicate removed) by the database searches; 94 were excluded based on title and Abstractreview; 82 article are searched for eligibility by full text review; 33 article cannot be accessed; 8 studies were reviews and case reports; 17 were not describing functional outcome; the desired procedure not used in 10 studies leaving 14 studies that met all inclusion criteria. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2022. Conclusion Spinopelvic surgical stabilization represents the “gold standard” for sacral fractures treatment, this technique guarantees stability, neutralizes flexion deformation, allowing early mobilization of the patient, ensuring a reduction of comorbidities and a better recovery of neurologic lesions.