Outcomes of Percutaneous Lumbopelvic Fixation in Patients with High Energy Sacral Trauma
Location
LSU Health NO Center for Advanced Learning and Simulation (CALS)
Document Type
Event
Start Date
20-6-2026 8:15 AM
End Date
20-6-2026 8:45 AM
Publication Date
June 2026
Description
Introduction: High energy, complex sacral and pelvic fractures can result in dissociation of the lumbar spine from the remainder of the sacrum and pelvis resulting in highly unstable fracture patterns. Lumbopelvic fixation entails stabilizing the lumbosacral junction through a surgical construct using pedicle screws, iliac screws, and connecting rods (Jazini et al). Stability and early weight bearing are key factors in the recovery of trauma patients. The goal of this study was to retrospectively review outcomes patients who had undergone lumbopelvic fixation with high energy sacral fractures, at a single level 1 trauma center. The authors focused on timing of pelvic stabilization and how this correlated with patient recovery. Secondarily, different methods of lumbopelvic stabilization were analyzed and compared.
Methods: 23 patients who had undergone lumbopelvic fixation at a single level 1 trauma center from 2019 to 2024 were retrospectively reviewed. Independent variables collected included demographics, fracture pattern, neurologic status, Gibbons grade, Injury severity score, concomitant injuries, injury mechanism, as well as timing and methods of stabilization. Outcome variables included length of stay, blood loss, length of operative time, complications, and time to mobilization.
Results: This case series included 23 patients who underwent lumbopelvic fixation including one pediatric patient, a 14-year-old female. Including all patients, the mean time to initial pelvic stabilization was 2.19 days (median 2), mean time between initial pelvic stabilization and lumbopelvic fixation was 6.4 (median 3) and mean total time to lumbopelvic fixation was 5.02 (median 3.21). Total time to lumbopelvic fixation had the highest correlation with time to mobilization (R squared value: 0.4). This was followed by time between initial pelvic stabilization and total time to mobilization (R squared value 0.2). Time to initial stabilization and total time to mobilization had an R squared value of .02. In terms of L4 to pelvis constructs versus L5, the L5 to pelvis group had on average less reported blood loss (285cc vs. 385 cc) and shorter operative time (2.17 hrs vs. 2.73 hrs). The L4 to pelvis group also had on average longer time to mobilization and length of stay. This group also had a slightly higher percentage of patients who were discharged to secondary care facilities (IPR, SNF).
Discussion: This study reports highly successful outcomes in cohort of patients undergoing minimally invasive lumbopelvic fixation for unstable sacral fractures. Of the three analyzed time intervals in this study, total time to lumbopelvic fixation appears to have the strongest correlation with patient recovery. These findings emphasize the importance of a multidisciplinary approach with early involvement of the spine trauma team. The authors demonstrated that L4 to pelvis constructs and L5 to pelvis constructs had similar indications and outcomes, while L5 to pelvis constructs had shorter operative time and less blood loss.
Significance/Clinical Relevance: Overall, this study adds to the literature of highly successful outcomes with minimally invasive lumbopelvic fixation and demonstrates its importance as a tool in the multidisciplinary treatment of highly unstable sacral fractures.
Recommended Citation
Gelvez, Daniel MD, "Outcomes of Percutaneous Lumbopelvic Fixation in Patients with High Energy Sacral Trauma" (2026). Dept. of Orthopaedics: Robert D. D’Ambrosia Lectureship & Research Day. 4.
https://digitalscholar.lsuhsc.edu/ortho_rd/2026/chief/4
Outcomes of Percutaneous Lumbopelvic Fixation in Patients with High Energy Sacral Trauma
LSU Health NO Center for Advanced Learning and Simulation (CALS)
Introduction: High energy, complex sacral and pelvic fractures can result in dissociation of the lumbar spine from the remainder of the sacrum and pelvis resulting in highly unstable fracture patterns. Lumbopelvic fixation entails stabilizing the lumbosacral junction through a surgical construct using pedicle screws, iliac screws, and connecting rods (Jazini et al). Stability and early weight bearing are key factors in the recovery of trauma patients. The goal of this study was to retrospectively review outcomes patients who had undergone lumbopelvic fixation with high energy sacral fractures, at a single level 1 trauma center. The authors focused on timing of pelvic stabilization and how this correlated with patient recovery. Secondarily, different methods of lumbopelvic stabilization were analyzed and compared.
Methods: 23 patients who had undergone lumbopelvic fixation at a single level 1 trauma center from 2019 to 2024 were retrospectively reviewed. Independent variables collected included demographics, fracture pattern, neurologic status, Gibbons grade, Injury severity score, concomitant injuries, injury mechanism, as well as timing and methods of stabilization. Outcome variables included length of stay, blood loss, length of operative time, complications, and time to mobilization.
Results: This case series included 23 patients who underwent lumbopelvic fixation including one pediatric patient, a 14-year-old female. Including all patients, the mean time to initial pelvic stabilization was 2.19 days (median 2), mean time between initial pelvic stabilization and lumbopelvic fixation was 6.4 (median 3) and mean total time to lumbopelvic fixation was 5.02 (median 3.21). Total time to lumbopelvic fixation had the highest correlation with time to mobilization (R squared value: 0.4). This was followed by time between initial pelvic stabilization and total time to mobilization (R squared value 0.2). Time to initial stabilization and total time to mobilization had an R squared value of .02. In terms of L4 to pelvis constructs versus L5, the L5 to pelvis group had on average less reported blood loss (285cc vs. 385 cc) and shorter operative time (2.17 hrs vs. 2.73 hrs). The L4 to pelvis group also had on average longer time to mobilization and length of stay. This group also had a slightly higher percentage of patients who were discharged to secondary care facilities (IPR, SNF).
Discussion: This study reports highly successful outcomes in cohort of patients undergoing minimally invasive lumbopelvic fixation for unstable sacral fractures. Of the three analyzed time intervals in this study, total time to lumbopelvic fixation appears to have the strongest correlation with patient recovery. These findings emphasize the importance of a multidisciplinary approach with early involvement of the spine trauma team. The authors demonstrated that L4 to pelvis constructs and L5 to pelvis constructs had similar indications and outcomes, while L5 to pelvis constructs had shorter operative time and less blood loss.
Significance/Clinical Relevance: Overall, this study adds to the literature of highly successful outcomes with minimally invasive lumbopelvic fixation and demonstrates its importance as a tool in the multidisciplinary treatment of highly unstable sacral fractures.