Injuries and Fractures of the Sacrum—A Comprehensive Review

Sacral fractures are highly heterogeneous disorders that range from low-energy fragility fractures to high-energy sacropelvic and lumbopelvic fracture-dislocations. Injuries may be isolated to the sacrum, associated with concomitant pelvic ring injuries and/or may involve the lumbosacral junction. Accurate diagnosis and classification of these unique injuries are critical for delivery of appropriate care. Good clinical results and improvement of functional outcomes can be achieved with well-indicated nonsurgical management and surgical stabilization. Surgical options are quite variable because they range from percutaneous posterior ring osteosynthesis to spinopelvic stabilization with or with neural decompression and reductions. This review will focus on diagnosis, classification, and management approaches to injuries of the sacrum, including nonsurgical, minimally invasive fixation, and spinopelvic stabilization options. The newest technology, as well as future directions, in this important field will also be presented.