Abstract
Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Although reports in the literature include nonoperative and operative management, most authors advocate for surgical treatment with open reduction and decompression with instrumentation and fusion. Despite advances in early diagnosis and management, this injury type is associated with significant morbidity and mortality, and long-term patient outcomes remain unclear.
Highlights
Traumatic lumbosacral dislocation is a rare clinical entity, characterized by unilateral or bilateral facet dislocations causing displacement at the level of the fifth lumbar vertebra in relation to the sacrum [1]
There is some discrepancy in the literature with regard to the terminology describing injuries in this region; traumatic L5-S1 spondylolisthesis [3,4,5,6,7], lumbosacral/lumbopelvic dissociation [8,9,10,11,12], suicide jumper’s fracture [13], spinopelvic dissociation [14,15,16,17], and spondylopelvic dissociation [18,19,20] have all been used to describe a spectrum of similar injuries
Sacral fractures and lumbosacral dislocations are estimated to account for 1% of spinal fractures [21]
Summary
Traumatic lumbosacral dislocation is a rare clinical entity, characterized by unilateral or bilateral facet dislocations causing displacement at the level of the fifth lumbar vertebra in relation to the sacrum [1]. This injury pattern is caused by high-energy mechanisms such as motor vehicle collisions, falls from height, and crush injuries and is frequently associated with severe concomitant injuries [2]. The terms spinopelvic and spondylopelvic dissociation are generally reserved for a more severe injury pattern with Utype, H-type, II-type, Y-type, or lambda type sacral fractures in conjunction with bilateral sacral fracture dislocations [17] In this injury pattern, the spine and upper sacrum displace into the pelvis, separating from the remainder of the intact pelvic ring. The aim of this present study was to review the current literature on lumbosacral dislocation with regard to the relevant anatomy, biomechanics of injury, classification schemes, clinical evaluation, management, and prognosis
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