ArticleClinics in orthopedic surgery2023
Value of Direct Decompression of Lumbosacral Roots in Sacral Fractures with Neurologic Deficit: Is It Mandatory?
Article in Clinics in orthopedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Future research focus and trends in nerve transplantation: a bibliometrics research from 2015 to 2024.Frontiers in neurology · 2025Pooled it
- Open and Percutaneous Fixation of Traumatic Sacral Fracture-Dislocation with Spinopelvic Dissociation: Two Adolescent Cases and a Systematic Literature Review.Journal of clinical medicine · 2026Review
- Traumatic lumbosacral instability: part 2-indications and techniques for surgical management.Archives of orthopaedic and trauma surgery · 2025Review
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Authors and funding
2 authors.
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Abstract
Background: The value of direct decompression of neural structures to treat lumbosacral plexus injury associated with sacral fractures is still debatable. Direct decompression allows decompression of nerve roots by sacral laminectomy and removal of bone fragments in the spinal canal. In contrast, indirect decompression may offer similar neurological outcomes if good fracture reduction and correction of sacral kyphosis are achieved. In this comparative retrospective study, we analyzed differences between direct and indirect neurological decompression in terms of neurological recovery, complications, and functional outcome. Methods: This study included 33 cases with spinopelvic dissociation with variable degrees of lumbosacral plexus injury. All cases were managed by spinopelvic fixation. Eighteen patients (group 1) had direct decompression of lumbosacral nerve roots while 15 patients (group 2) had indirect decompression. Results: Initial sacral kyphosis, quality of fracture reduction, and postoperative residual kyphosis were the main factors that significantly affected functional and neurological outcome in both groups. The final neurological improvement was similar in both groups. No significant difference was observed between both groups in the residual Gibbons' score recorded in the last visit ( Conclusions: Indirect decompression of sacral fractures showed similar final functional outcome and neurological recovery compared to direct decompression. Restoration of lumbosacropelvic stability and anatomic reduction seem to be the cornerstone for better functional outcome and neurological recovery rather than direct decompression of neural elements.
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