OBJECTIVES:
To evaluate the effectiveness of transsacral-transiliac screw fixation for the treatment of sacral insufficiency fractures that fail nonoperative treatment.

DESIGN:
A pilot study series of consecutive patients identified over 5 years were treated and followed prospectively.

SETTING:
Academic-affiliated, tertiary referral, level 1 trauma center in Dallas, TX.

PATIENTS/PARTICIPANTS:
Patients were selected on the basis of presenting diagnosis, and failure of nonoperative treatment of their sacral insufficiency fracture. Eleven patients entered to the study, and 10 completed follow-up.

INTERVENTION:
Placement of transsacral-transiliac screws for sacral insufficiency fracture.

MAIN OUTCOME MEASUREMENTS:
Comparison of preoperative and postoperative Visual Analog Scale scores and Oswestry Low Back Disability Index scores.

RESULTS:
Patients experienced statistically significant improvement in both outcome measures after intervention. No complications encountered.

CONCLUSIONS:
Transsacral-transiliac screw fixation seems to be a safe and effective treatment for sacral insufficiency fractures recalcitrant to nonoperative management.

LEVEL OF EVIDENCE:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.





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