PMC6476123_01
Lumbosacral magnetic resonance imaging with short inversion time inversion recovery (STIR) sequence shows an H-shaped sacrum fracture. Bilateral vertical fractures of the lateral mass of the sacrum and horizontal fracture at the level of the S2 neural foramina are visible.
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Lumbosacral magnetic resonance imaging using a short inversion time inversion recovery (STIR) sequence revealed an H-shaped fracture in the sacrum, but there were no abnormal findings such as spinal stenosis in her lumbar spine potentially explaining for her neurological symptoms (Figure 1).
Coronal sacral CT images obtained at the first visit (a), admission (b), and final follow-up (c). The initial CT revealed nondisplaced bilateral fracture of the lateral mass of the sacrum (white arrow head). At the time of admission, CT showed slightly aggravated displacement of the fracture (white arrow head). CT at the final follow-up demonstrated bony union of the sacral lateral mass fracture. CT: computed tomography.
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Repeated CT demonstrated slightly aggravated displacement of the sacral fracture compared with previous CT (Figure 2).
Postoperative anteroposterior radiograph. Percutaneous pedicle screws were inserted in L3 and L4, and 2 iliac screws were inserted on each side. Bilateral iliac screws were connected by 2 transverse rods and a crosslink. The crossing points of rods for lumbar pedicle screws and the cranial transverse rod for iliac screws were connected by rod connectors, completing lumbopelvic fixation.
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SIF and recommended that she undergo surgery. She underwent lumbopelvic fixation from L3 to the ilium using a minimally invasive technique with a percutaneous pedicle screw system (Figure 3).