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Subacute Minimally Invasive Decompression of L5 and S1 Nerve Roots for Neurologic Deficit After Fixation of Unstable Pelvic Fracture: A Case Report and Review of the Literature.

Subacute Minimally Invasive Decompression of L5 and S1 Nerve Roots for Neurologic Deficit After Fixation of Unstable Pelvic Fracture: A Case Report and Review of the Literature. JBJS case connector Warren, S., Gardner, M., Alamin, T. 2020; 10 (3): e1900638

Abstract

CASE: A 73-year-old man experienced immediate neurological decline after percutaneous transsacral screw fixation for a pelvic ring injury sustained after a 25-foot fall. Workup revealed well-positioned screws and compression of the right L5 and S1 nerve roots at the fracture site. Symptoms improved after direct decompression without screw revision.CONCLUSION: The courses of the L5 and S1 nerve roots place them at risk of compression within the fracture during transsacral screw fixation. In highly comminuted fractures, avoidance of compression screws or use of intraoperative CT might prevent this complication. Direct nerve root decompression alone can be a successful treatment.

View details for DOI 10.2106/JBJS.CC.19.00638

View details for PubMedID 32773717