Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Dec;34(8):4057-4063.
doi: 10.1007/s00590-024-04107-1. Epub 2024 Sep 23.

L5-S1 facet joint pathology in pelvic ring injuries

Nicholas C Danford  1 , Celeste Tavolaro  2 , Suzanna Ohlsen  2 , Bilal Khilfeh  2 , Julie Agel  2 , Michael Githens  2 , Conor Kleweno  2 , Carlo Bellabarba  2 , Reza Firoozabadi  2
Affiliations
Comparative Study

L5-S1 facet joint pathology in pelvic ring injuries

Nicholas C Danford et al. Eur J Orthop Surg Traumatol. 2024 Dec.

Abstract

Background: The authors believe that the L5-S1 facet joint injury in the setting of pelvic fractures is underappreciated by orthopedic traumatologists. The purpose of this study was to draw attention to the L5/S1 facet joint in the setting of pelvic ring injuries.

Methods: This was a retrospective comparative study of all patients greater than or equal to 18 years of age with an acute pelvic ring injury (AO/OTA 62 B to C) presenting to a single level I trauma center. The primary objective was to determine demographic and injury characteristics associated with L5-S1 facet joint injuries in patients with pelvic ring injuries. The secondary objective was to determine the proportion of L5-S1 facet joint injuries that were missed on initial radiographic workup.

Results: There were 476 patients included in the analysis, 53 (11.1%) of whom had an L5-S1 facet joint injury. Patients with an L5-S1 injury were more likely to be younger (44.1 vs. 53.2 years, p = 0.001) and experience a high energy mechanism of injury (95.0% vs. 78.0%, p = 0.002). Certain injury patterns were associated with L5-S1 facet joint injuries: any sacral fracture (96.2% vs. 73.8%, p < 0.001), Denis zone 2 fractures (43.4% vs. 20.1%, p < 0.001), Denis zone 3 fractures (34.0% vs. 4.7%, p < 0.001), bilateral displaced sacral fractures (18.9% vs. 3.5%, p < 0.001), and L5 transverse process fractures (64.2% vs. 18.0%, p < 0.001). Only 16.0% of radiology reports identified an L5-S1 injury.

Conclusions: Orthopedic traumatologists should scrutinize imaging for L5-S1 facet joint injuries in the presence of pelvic ring injuries, especially in patients with certain sacral fracture patterns.

Keywords: L5-S1 facet injury; Lumbopelvic fixation; Missed injury; Pelvic ring injury; Spinopelvic fixation.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Brouwers L, Lansink KWW, de Jongh MAC (2018) Quality of life after pelvic ring fractures: a cross-sectional study. Injury 49(4):812–818. https://doi.org/10.1016/j.injury.2018.03.012 - DOI - PubMed
    1. Martin MP 3rd, Rojas D, Dean CS, Lockwood W, Nadeau J, Maertens A, Parry J, Maher M, Funk A, Stacey S, Burlew CC, Mauffrey C (2021) Psychological outcomes affect functional outcomes in patients with severe pelvic ring fractures. Injury 52(10):2750–2753. https://doi.org/10.1016/j.injury.2020.02.071 - DOI - PubMed
    1. Dean CS, Nadeau J, Strage KE, Tucker NJ, Chambers L, Worster K, Rojas D, Schneider G, Johnson T, Hunt K, Parry JA, Mauffrey C (2022) Analysis of postoperative gait, hip strength, and patient-reported outcomes after OTA/AO 61-B and 61-C pelvic ring injuries. J Orthop Trauma 36(9):432–438. https://doi.org/10.1097/BOT.0000000000002359 - DOI - PubMed
    1. Leone A, Cerase A, Priolo F, Marano P (1997) Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology 205(1):253–259. https://doi.org/10.1148/radiology.205.1.9314994 - DOI - PubMed
    1. Oransky M, Gasparini G (1997) Associated lumbosacral junction injuries (LSJIs) in pelvic fractures. J Orthop Trauma 11(7):509–512. https://doi.org/10.1097/00005131-199710000-00008 - DOI - PubMed

Publication types

LinkOut - more resources