Surgical stabilization options for fractures and fracture-dislocations at the lumbosacral junction and for posterior pelvic ring reconstruction

The pelvic ring and lumbar spinal transition zone provide our trunk and lower extremities with a sound structural foundation and conduit for neurovascular structures, as well as a floor to our intestines and uro-genital structures. Injuries to this area are typically the result of high-energy injuries, neoplastic disease, or insufficiency fractures in the presence of impaired bone substance. Due to its unique reliance on a combination of firm bony structures encased by strong ligamentous support structures, the pelvic ring and lumbosacral juncture are exposed to a wide variety of possible injury constellations in terms of musculoskeletal injuries and associated organ system injuries. Ultimately, preservation or restoration of the three-dimensional alignment of this region with a solidly healed injury zone is desirable. The goals of surgical treatment of pelvic ring and lumbosacral zone injuries are providing an environment to allow for best possible regeneration of neural injury and facilitating the recovery process through early pain-free mobilization without interfering with the care of other injured organ systems.