{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:41:52Z","timestamp":1784256112899,"version":"3.55.0"},"reference-count":98,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Innsbruck and Medical University of Innsbruck"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Traumatic lumbosacral instability (TLSI) generally refers to a traumatic disruption of the lumbopelvic junction. The ambiguous use of this term has contributed to confusion and limited understanding of injuries that can impact lumbosacral stability. As of now, TLSI lacks a clear definition, and the underlying injury patterns remain inadequately characterized. Therefore, the objectives of the first part of this two-part series are: (1) to establish a precise definition of TLSI, (2) to identify and systematically characterize the injury patterns underlying TLSI, and (3) to outline principles for diagnosing and classifying these underlying conditions.<\/jats:p>","DOI":"10.1007\/s00402-024-05604-y","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T07:31:05Z","timestamp":1733988665000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Traumatic lumbosacral instability: part 1 \u2013 proposing a definition and identifying underlying injury patterns"],"prefix":"10.1007","volume":"145","author":[{"given":"Richard A.","family":"Lindtner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Krappinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Lindahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Bellabarba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"issue":"11 Suppl","key":"5604_CR1","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1097\/01.brs.0000217949.31762.be","volume":"31","author":"C Bellabarba","year":"2006","unstructured":"Bellabarba C, Schildhauer TA, Vaccaro AR, Chapman JR (2006) Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability. Spine 31(11 Suppl):S80\u2013S88","journal-title":"Spine"},{"issue":"8","key":"5604_CR2","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/j.injury.2012.05.003","volume":"43","author":"GQ Tan","year":"2012","unstructured":"Tan GQ, He JL, Fu BS, Li LX, Wang BM, Zhou DS (2012) Lumbopelvic fixation for multiplanar sacral fractures with spinopelvic instability. Injury 43(8):1318\u20131325","journal-title":"Injury"},{"issue":"1","key":"5604_CR3","doi-asserted-by":"crossref","first-page":"14878","DOI":"10.1038\/s41598-020-71498-6","volume":"10","author":"E Yilmaz","year":"2020","unstructured":"Yilmaz E, Hoffmann MF, von Glinski A et al (2020) Functional outcome of traumatic spinopelvic instabilities treated with lumbopelvic fixation. Sci Rep 10(1):14878","journal-title":"Sci Rep"},{"issue":"4","key":"5604_CR4","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00402-024-05211-x","volume":"144","author":"P Godolias","year":"2024","unstructured":"Godolias P, Pl\u00fcmer J, Cibura C, Dudda M, Schildhauer TA, Chapman JR (2024) Posterior pelvic ring injuries, lumbosacral junction instabilities and stabilization techniques for spinopelvic dissociation: a narrative review. Arch Orthop Trauma Surg 144(4):1627\u20131635","journal-title":"Arch Orthop Trauma Surg"},{"issue":"7","key":"5604_CR5","doi-asserted-by":"crossref","first-page":"E469","DOI":"10.1097\/BRS.0b013e3182077fd7","volume":"36","author":"MD Helgeson","year":"2011","unstructured":"Helgeson MD, Lehman RA Jr., Cooper P, Frisch M, Andersen RC, Bellabarba C (2011) Retrospective review of lumbosacral dissociations in blast injuries. Spine (Phila Pa 1976) 36(7):E469\u2013475","journal-title":"Spine (Phila Pa 1976)"},{"issue":"10","key":"5604_CR6","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.spinee.2016.06.008","volume":"16","author":"PM Formby","year":"2016","unstructured":"Formby PM, Wagner SC, Kang DG, Van Blarcum GS, Lehman RA Jr (2016) Operative management of complex lumbosacral dissociations in combat injuries. Spine J 16(10):1200\u20131207","journal-title":"Spine J"},{"issue":"11","key":"5604_CR7","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1007\/s00113-012-2335-4","volume":"116","author":"M Dudda","year":"2013","unstructured":"Dudda M, Hoffmann M, Schildhauer TA (2013) [Sacrum fractures and lumbopelvic instabilities in pelvic ring injuries: classification and biomechanical aspects]. Unfallchirurg 116(11):972\u2013978","journal-title":"Unfallchirurg"},{"issue":"Suppl 4","key":"5604_CR8","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/j.injury.2016.07.046","volume":"47","author":"F De Iure","year":"2016","unstructured":"De Iure F, Cappuccio M, Palmisani M, Pascarella R, Commessatti M (2016) Lumboiliac fixation in lumbosacral dislocation and associated injuries of the pelvis and lumbosacral junction: a long-term radiological and clinical follow-up. Injury 47(Suppl 4):S44\u2013s48","journal-title":"Injury"},{"issue":"Suppl 6","key":"5604_CR9","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S0020-1383(17)30789-1","volume":"48","author":"ALL Barcellos","year":"2017","unstructured":"Barcellos ALL, da Rocha VM, Guimar\u00e3es JAM (2017) Current concepts in spondylopelvic dissociation. Injury 48(Suppl 6):S5\u2013s11","journal-title":"Injury"},{"issue":"9","key":"5604_CR10","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1097\/00007632-198511000-00011","volume":"10","author":"R Roy-Camille","year":"1985","unstructured":"Roy-Camille R, Saillant G, Gagna G, Mazel C (1985) Transverse fracture of the upper sacrum. Suicidal jumper\u2019s fracture. Spine 10(9):838\u2013849","journal-title":"Spine"},{"issue":"4","key":"5604_CR11","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/00005131-200105000-00002","volume":"15","author":"SE Nork","year":"2001","unstructured":"Nork SE, Jones CB, Harding SP, Mirza SK, Routt ML Jr (2001) Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results. J Orthop Trauma 15(4):238\u2013246","journal-title":"J Orthop Trauma"},{"issue":"7","key":"5604_CR12","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/00005131-200608000-00001","volume":"20","author":"TA Schildhauer","year":"2006","unstructured":"Schildhauer TA, Bellabarba C, Nork SE, Barei DP, Routt ML Jr., Chapman JR (2006) Decompression and lumbopelvic fixation for sacral fracture-dislocations with spino-pelvic dissociation. J Orthop Trauma 20(7):447\u2013457","journal-title":"J Orthop Trauma"},{"issue":"12","key":"5604_CR13","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1016\/j.injury.2014.09.003","volume":"45","author":"J Lindahl","year":"2014","unstructured":"Lindahl J, M\u00e4kinen TJ, Koskinen SK, S\u00f6derlund T (2014) Factors associated with outcome of spinopelvic dissociation treated with lumbopelvic fixation. Injury 45(12):1914\u20131920","journal-title":"Injury"},{"issue":"4","key":"5604_CR14","doi-asserted-by":"crossref","first-page":"e198","DOI":"10.5435\/JAAOS-D-19-00293","volume":"29","author":"HC B\u00e4cker","year":"2021","unstructured":"B\u00e4cker HC, Vosseller JT, Deml MC, Perka C, Putzier M (2021) Spinopelvic dissociation: a systematic review and Meta-analysis. J Am Acad Orthop Surg 29(4):e198\u2013e207","journal-title":"J Am Acad Orthop Surg"},{"issue":"4","key":"5604_CR15","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.injury.2009.06.008","volume":"41","author":"R Schmid","year":"2010","unstructured":"Schmid R, Reinhold M, Blauth M (2010) Lumbosacral dislocation: a review of the literature and current aspects of management. Injury 41(4):321\u2013328","journal-title":"Injury"},{"issue":"2","key":"5604_CR16","first-page":"449","volume":"64","author":"O Hauschild","year":"2008","unstructured":"Hauschild O, Strohm PC, Culemann U et al (2008) Mortality in patients with pelvic fractures: results from the German pelvic injury register. J Trauma 64(2):449\u2013455","journal-title":"J Trauma"},{"issue":"18","key":"5604_CR17","doi-asserted-by":"crossref","first-page":"E1103","DOI":"10.1097\/BRS.0000000000000448","volume":"39","author":"M Bydon","year":"2014","unstructured":"Bydon M, De la Garza-Ramos R, Macki M, Desai A, Gokaslan AK, Bydon A (2014) Incidence of sacral fractures and in-hospital postoperative complications in the United States: an analysis of 2002\u20132011 data. Spine 39(18):E1103\u2013E1109","journal-title":"Spine"},{"issue":"8","key":"5604_CR18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2106\/JBJS.RVW.20.00196","volume":"9","author":"JP Wanner","year":"2021","unstructured":"Wanner JP, Tatman L, Stephens B, Mitchell P (2021) Team Approach: spinopelvic dissociation. JBJS Rev 9(8):1","journal-title":"JBJS Rev"},{"issue":"5","key":"5604_CR19","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1530\/EOR-23-0059","volume":"8","author":"C Court","year":"2023","unstructured":"Court C, Chatelain L, Valteau B, Bouthors C (2023) Surgical management of lumbosacral and sacral fractures: roles of the pelvic and spinal surgeons. EFORT Open Rev 8(5):361\u2013371","journal-title":"EFORT Open Rev"},{"issue":"5","key":"5604_CR20","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/BSD.0000000000000385","volume":"29","author":"RA Lindtner","year":"2016","unstructured":"Lindtner RA, Bellabarba C, Firoozabadi R et al (2016) Should Displaced Sacral fractures be treated by an Orthopedic traumatologist or a spine surgeon? Clin Spine Surg 29(5):173\u2013176","journal-title":"Clin Spine Surg"},{"issue":"12","key":"5604_CR21","doi-asserted-by":"crossref","first-page":"656","DOI":"10.5435\/00124635-200611000-00009","volume":"14","author":"S Mehta","year":"2006","unstructured":"Mehta S, Auerbach JD, Born CT, Chin KR (2006) Sacral fractures. J Am Acad Orthop Surg 14(12):656\u2013665","journal-title":"J Am Acad Orthop Surg"},{"issue":"10","key":"5604_CR22","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1007\/s00586-019-05983-6","volume":"29","author":"HC B\u00e4cker","year":"2020","unstructured":"B\u00e4cker HC, Wu CH, Vosseller JT et al (2020) Spinopelvic dissociation in patients suffering injuries from airborne sports. Eur Spine J 29(10):2513\u20132520","journal-title":"Eur Spine J"},{"issue":"7","key":"5604_CR23","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1177\/2192568217701097","volume":"7","author":"R Rodrigues-Pinto","year":"2017","unstructured":"Rodrigues-Pinto R, Kurd MF, Schroeder GD et al (2017) Sacral fractures and Associated Injuries. Global Spine J 7(7):609\u2013616","journal-title":"Global Spine J"},{"issue":"1","key":"5604_CR24","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ocl.2013.08.002","volume":"45","author":"MP Sullivan","year":"2014","unstructured":"Sullivan MP, Smith HE, Schuster JM, Donegan D, Mehta S, Ahn J (2014) Spondylopelvic dissociation. Orthop Clin North Am 45(1):65\u201375","journal-title":"Orthop Clin North Am"},{"issue":"5","key":"5604_CR25","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00586-011-2125-7","volume":"21","author":"MA K\u00f6nig","year":"2012","unstructured":"K\u00f6nig MA, Jehan S, Boszczyk AA, Boszczyk BM (2012) Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies. Eur Spine J 21(5):829\u2013836","journal-title":"Eur Spine J"},{"issue":"7","key":"5604_CR26","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.spinee.2012.01.009","volume":"12","author":"RA Lehman Jr","year":"2012","unstructured":"Lehman RA Jr., Kang DG, Bellabarba C (2012) A new classification for complex lumbosacral injuries. Spine J 12(7):612\u2013628","journal-title":"Spine J"},{"issue":"3","key":"5604_CR27","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.injury.2018.03.001","volume":"49","author":"E Guerado","year":"2018","unstructured":"Guerado E, Cervan AM, Cano JR, Giannoudis PV (2018) Spinopelvic injuries. Facts and controversies. Injury 49(3):449\u2013456","journal-title":"Injury"},{"issue":"2","key":"5604_CR28","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.injury.2022.10.008","volume":"54","author":"CA Morris","year":"2023","unstructured":"Morris CA, Moo Young JP, Savakus JC et al (2023) Neurologic injury after spinopelvic dissociation: incidence, outcome, and predictors. Injury 54(2):615\u2013619","journal-title":"Injury"},{"issue":"4","key":"5604_CR29","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/BOT.0000000000000772","volume":"31","author":"JM Khan","year":"2017","unstructured":"Khan JM, Marquez-Lara A, Miller AN (2017) Relationship of sacral fractures to nerve Injury: is the Denis classification still Accurate? J Orthop Trauma 31(4):181\u2013184","journal-title":"J Orthop Trauma"},{"issue":"1","key":"5604_CR30","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.spinee.2007.08.006","volume":"9","author":"LA Robles","year":"2009","unstructured":"Robles LA (2009) Transverse sacral fractures. Spine J 9(1):60\u201369","journal-title":"Spine J"},{"issue":"3","key":"5604_CR31","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/01.TA.0000032250.77735.54","volume":"56","author":"FH Shen","year":"2004","unstructured":"Shen FH, Crowl A, Shuler TE, Feldenzer JA, Leivy SW (2004) Delayed recognition of lumbosacral fracture dislocations in the multitrauma patient: the triad of transverse process fractures, unilateral renal contusion and lumbosacral fracture dislocation. J Trauma 56(3):700\u2013705","journal-title":"J Trauma"},{"issue":"4","key":"5604_CR32","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.2214\/AJR.09.3402","volume":"194","author":"JA Porrino Jr","year":"2010","unstructured":"Porrino JA Jr., Kohl CA, Holden D, Taljanovic M, Rogers LF (2010) The importance of sagittal 2D reconstruction in pelvic and sacral trauma: avoiding oversight of U-shaped fractures of the sacrum. AJR Am J Roentgenol 194(4):1065\u20131071","journal-title":"AJR Am J Roentgenol"},{"issue":"6","key":"5604_CR33","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s10140-021-01966-7","volume":"28","author":"JT Patterson","year":"2021","unstructured":"Patterson JT, Lack WD, Agel J et al (2021) AP pelvis radiograph is insufficient for diagnosis of U-type sacral fractures. Emerg Radiol 28(6):1119\u20131126","journal-title":"Emerg Radiol"},{"issue":"2","key":"5604_CR34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2106\/JBJS.CC.20.00479","volume":"11","author":"A Achalare","year":"2021","unstructured":"Achalare A, Dhawale A, Chaudhary K, Thorat T, Jain P, Daver G (2021) Delayed treatment of a traumatic lumbosacral dislocation with Associated injuries a Case Report. JBJS Case Connect 11(2):1","journal-title":"JBJS Case Connect"},{"key":"5604_CR35","first-page":"6578097","volume":"2018","author":"AS Moon","year":"2018","unstructured":"Moon AS, Atesok K, Niemeier TE, Manoharan SR, Pittman JL, Theiss SM (2018) Traumatic Lumbosacral Dislocation: Current Concepts in Diagnosis and Management. Adv Orthop 2018:6578097","journal-title":"Adv Orthop"},{"issue":"7","key":"5604_CR36","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1097\/BOT.0000000000000821","volume":"31","author":"HD Lee","year":"2017","unstructured":"Lee HD, Jeon CH, Won SH, Chung NS (2017) Global Sagittal Imbalance due to change in pelvic incidence after traumatic spinopelvic dissociation. J Orthop Trauma 31(7):e195\u2013e199","journal-title":"J Orthop Trauma"},{"key":"5604_CR37","first-page":"1365","volume-title":"Rothman-Simeone and Herkowitz\u2019s The Spine","author":"C Bellabarba","year":"2017","unstructured":"Bellabarba C, Lindtner RA, Bransford RJ (2017) Sacral Fractures. In: Garfin SR, Eismont FJ, Bell GR, Fischgrund JS, Bono CM (eds) Rothman-Simeone and Herkowitz\u2019s The Spine, 7th edn. Elsevier, Philadelphia, pp 1365\u20131388","edition":"7"},{"issue":"1","key":"5604_CR38","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00007632-198501000-00009","volume":"10","author":"JP Van Schaik","year":"1985","unstructured":"Van Schaik JP, Verbiest H, Van Schaik FD (1985) The orientation of laminae and facet joints in the lower lumbar spine. Spine 10(1):59\u201363","journal-title":"Spine"},{"issue":"16","key":"5604_CR39","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1097\/01.BRS.0000134575.04084.EF","volume":"29","author":"Y Masharawi","year":"2004","unstructured":"Masharawi Y, Rothschild B, Dar G et al (2004) Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis. Spine (Phila Pa 1976) 29(16):1755\u20131763","journal-title":"Spine (Phila Pa 1976)"},{"issue":"16","key":"5604_CR40","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.2106\/JBJS.19.01153","volume":"102","author":"AR Vaccaro","year":"2020","unstructured":"Vaccaro AR, Schroeder GD, Divi SN et al (2020) Description and reliability of the AOSpine Sacral classification system. J Bone Joint Surg Am 102(16):1454\u20131463","journal-title":"J Bone Joint Surg Am"},{"issue":"Suppl 1","key":"5604_CR41","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","volume":"32","author":"EG Meinberg","year":"2018","unstructured":"Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF (2018) Fracture and dislocation classification Compendium-2018. J Orthop Trauma 32(Suppl 1):S1\u2013s170","journal-title":"J Orthop Trauma"},{"issue":"12","key":"5604_CR42","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1097\/BOT.0000000000000972","volume":"31","author":"JA Bishop","year":"2017","unstructured":"Bishop JA, Dangelmajer S, Corcoran-Schwartz I, Gardner MJ, Routt MLC Jr., Castillo TN (2017) Bilateral Sacral Ala fractures are strongly Associated with Lumbopelvic instability. J Orthop Trauma 31(12):636\u2013639","journal-title":"J Orthop Trauma"},{"issue":"2","key":"5604_CR43","doi-asserted-by":"crossref","first-page":"346","DOI":"10.2106\/00004623-200302000-00026","volume":"85","author":"RM Meneghini","year":"2003","unstructured":"Meneghini RM, DeWald CJ (2003) Traumatic posterior spondyloptosis at the lumbosacral junction. A case report. J Bone Joint Surg Am 85(2):346\u2013350","journal-title":"J Bone Joint Surg Am"},{"issue":"17","key":"5604_CR44","doi-asserted-by":"crossref","first-page":"E629","DOI":"10.1097\/BRS.0b013e3181aa2e1a","volume":"34","author":"L Verhelst","year":"2009","unstructured":"Verhelst L, Ackerman P, Van Meirhaeghe J (2009) Traumatic posterior lumbosacral spondyloptosis in a six-year-old: a case report and review of the literature. Spine (Phila Pa 1976) 34(17):E629\u2013634","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"5604_CR45","first-page":"286","volume":"18","author":"R Vialle","year":"2005","unstructured":"Vialle R, Court C (2005) Traumatic lateral lumbosacral dislocation: one case and review of literature. J Spinal Disord Tech 18(3):286\u2013289","journal-title":"J Spinal Disord Tech"},{"issue":"1","key":"5604_CR46","doi-asserted-by":"crossref","first-page":"E56","DOI":"10.1097\/BSD.0000000000000084","volume":"28","author":"NR Arandi","year":"2015","unstructured":"Arandi NR, Mundis GM Jr., Kabirian N, Zhang D, Schroerlucke S (2015) Traumatic complete lateral dislocation at the lumbosacral junction: a case report. J Spinal Disord Tech 28(1):E56\u201360","journal-title":"J Spinal Disord Tech"},{"key":"5604_CR47","volume-title":"Fractures and other bone and joint injuries","author":"R Watson-Jones","year":"1941","unstructured":"Watson-Jones R (1941) Fractures and other bone and joint injuries. Williams & Wilkins, Baltimore"},{"issue":"10","key":"5604_CR48","first-page":"e30417","volume":"14","author":"G Santangelo","year":"2022","unstructured":"Santangelo G, Catanzaro S, Contento N, Rahmani R, Silberstein H (2022) Pediatric bilateral Lumbosacral dislocation without fracture: an exemplary case and literature review. Cureus 14(10):e30417","journal-title":"Cureus"},{"key":"5604_CR49","doi-asserted-by":"crossref","first-page":"133","DOI":"10.25259\/SNI_234_2023","volume":"14","author":"LSS Bhenderu","year":"2023","unstructured":"Bhenderu LSS, Lyon KA, Richardson WT, Desai R, Kriel HH, Rahm MD (2023) Treatment of unilateral L5-S1 locked facet in a pediatric patient. Surg Neurol Int 14:133","journal-title":"Surg Neurol Int"},{"issue":"4","key":"5604_CR50","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1159\/000488766","volume":"53","author":"VN Yamaki","year":"2018","unstructured":"Yamaki VN, Morais BA, Brock RS, Paiva WS, de Andrade AF, Teixeira MJ (2018) Traumatic lumbosacral spondyloptosis in a Pediatric patient: Case Report and Literature Review. Pediatr Neurosurg 53(4):263\u2013269","journal-title":"Pediatr Neurosurg"},{"issue":"5","key":"5604_CR51","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1302\/0301-620X.80B5.0800840","volume":"80","author":"T Aihara","year":"1998","unstructured":"Aihara T, Takahashi K, Yamagata M, Moriya H (1998) Fracture-dislocation of the fifth lumbar vertebra. A new classification. J Bone Joint Surg Br 80(5):840\u2013845","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"5604_CR52","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.injury.2006.06.015","volume":"38","author":"R Vialle","year":"2007","unstructured":"Vialle R, Charosky S, Rillardon L, Levassor N, Court C (2007) Traumatic dislocation of the lumbosacral junction diagnosis, anatomical classification and surgical strategy. Injury 38(2):169\u2013181","journal-title":"Injury"},{"issue":"7","key":"5604_CR53","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1177\/2192568218801882","volume":"9","author":"MLP Ver","year":"2019","unstructured":"Ver MLP, Dimar JR 2nd, Carreon LY (2019) Traumatic lumbar spondylolisthesis: a systematic review and Case Series. Global Spine J 9(7):767\u2013782","journal-title":"Global Spine J"},{"issue":"9","key":"5604_CR54","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1007\/s00402-005-0078-1","volume":"126","author":"M Reinhold","year":"2006","unstructured":"Reinhold M, Knop C, Blauth M (2006) Acute traumatic L5-S1 spondylolisthesis: a case report. Arch Orthop Trauma Surg 126(9):624\u2013630","journal-title":"Arch Orthop Trauma Surg"},{"issue":"9","key":"5604_CR55","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1097\/00007632-199705010-00016","volume":"22","author":"DK Steinitz","year":"1997","unstructured":"Steinitz DK, Alexander DI, Leighton RK, O\u2019Sullivan JJ (1997) Late displacement of a fracture dislocation at the lumbosacral junction. A case study. Spine (Phila Pa 1976) 22(9):1024\u20131027","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"5604_CR56","first-page":"232","volume":"18","author":"PA Robertson","year":"2005","unstructured":"Robertson PA, Sherwood MJ, Hadlow AT (2005) Lumbosacral dislocation injuries: management and outcomes. J Spinal Disord Tech 18(3):232\u2013237","journal-title":"J Spinal Disord Tech"},{"issue":"6","key":"5604_CR57","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s00256-003-0626-0","volume":"32","author":"C Tohme-Noun","year":"2003","unstructured":"Tohme-Noun C, Rillardon L, Krainik A, Guigui P, Menu Y, Feydy A (2003) Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation. Skeletal Radiol 32(6):360\u2013363","journal-title":"Skeletal Radiol"},{"issue":"1","key":"5604_CR58","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1055\/s-0033-1357082","volume":"4","author":"B Akesen","year":"2014","unstructured":"Akesen B, Mutlu M, Kara K, Ayd\u0131nl\u0131 U (2014) Traumatic lumbosacral spondyloptosis: a case report and review of the literature. Global Spine J 4(1):59\u201362","journal-title":"Global Spine J"},{"issue":"4","key":"5604_CR59","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.injury.2011.08.036","volume":"43","author":"HC Liu","year":"2012","unstructured":"Liu HC, Chen YZ, Sang XG, Qi L (2012) Management of lumbosacropelvic fracture-dislocation using lumbo-iliac internal fixation. Injury 43(4):452\u2013457","journal-title":"Injury"},{"issue":"16","key":"5604_CR60","doi-asserted-by":"crossref","first-page":"E1028","DOI":"10.1097\/BRS.0b013e318297960a","volume":"38","author":"SS Bederman","year":"2013","unstructured":"Bederman SS, Hassan JM, Shah KN, Kiester PD, Bhatia NN, Zamorano DP (2013) Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine (Phila Pa 1976) 38(16):E1028\u20131040","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"5604_CR61","doi-asserted-by":"crossref","first-page":"889","DOI":"10.3171\/jns.1990.72.6.0889","volume":"72","author":"KJ Gibbons","year":"1990","unstructured":"Gibbons KJ, Soloniuk DS, Razack N (1990) Neurological injury and patterns of sacral fractures. J Neurosurg 72(6):889\u2013893","journal-title":"J Neurosurg"},{"issue":"6","key":"5604_CR62","first-page":"400","volume":"21","author":"T Pohlemann","year":"1992","unstructured":"Pohlemann T, G\u00e4nsslen A, Tscherne H (1992) [The problem of the sacrum fracture. Clinical analysis of 377 cases]. Orthopade 21(6):400\u2013412","journal-title":"Orthopade"},{"key":"5604_CR63","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00003086-198802000-00010","volume":"227","author":"F Denis","year":"1988","unstructured":"Denis F, Davis S, Comfort T (1988) Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 227:67\u201381","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"5604_CR64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005131-199003000-00001","volume":"4","author":"B Isler","year":"1990","unstructured":"Isler B (1990) Lumbosacral lesions associated with pelvic ring injuries. J Orthop Trauma 4(1):1\u20136","journal-title":"J Orthop Trauma"},{"issue":"4","key":"5604_CR65","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1097\/00005373-200010000-00027","volume":"49","author":"M Hessmann","year":"2000","unstructured":"Hessmann M, Degreif J, Mayer A, Atahi S, Rommens PM (2000) Transverse sacral fracture with intrapelvic intrusion of the lumbosacral spine: case report and review of the literature. J Trauma 49(4):754\u2013757","journal-title":"J Trauma"},{"issue":"10","key":"5604_CR66","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.injury.2008.11.027","volume":"40","author":"AJ Gribnau","year":"2009","unstructured":"Gribnau AJ, van Hensbroek PB, Haverlag R, Ponsen KJ, Been HD, Goslings JC (2009) U-shaped sacral fractures: surgical treatment and quality of life. Injury 40(10):1040\u20131048","journal-title":"Injury"},{"issue":"4","key":"5604_CR67","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.injury.2010.12.011","volume":"43","author":"C Yi","year":"2012","unstructured":"Yi C, Hak DJ (2012) Traumatic spinopelvic dissociation or U-shaped sacral fracture: a review of the literature. Injury 43(4):402\u2013408","journal-title":"Injury"},{"issue":"9","key":"5604_CR68","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1007\/s00586-012-2406-9","volume":"21","author":"MA Ayoub","year":"2012","unstructured":"Ayoub MA (2012) Displaced spinopelvic dissociation with sacral cauda equina syndrome: outcome of surgical decompression with a preliminary management algorithm. Eur Spine J 21(9):1815\u20131825","journal-title":"Eur Spine J"},{"issue":"3","key":"5604_CR69","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s10140-016-1383-4","volume":"23","author":"P Gupta","year":"2016","unstructured":"Gupta P, Barnwell JC, Lenchik L, Wuertzer SD, Miller AN (2016) Spinopelvic dissociation: multidetector computed tomographic evaluation of fracture patterns and associated injuries at a single level 1 trauma center. Emerg Radiol 23(3):235\u2013240","journal-title":"Emerg Radiol"},{"issue":"3","key":"5604_CR70","doi-asserted-by":"crossref","first-page":"E12","DOI":"10.3171\/2009.12.FOCUS09265","volume":"28","author":"NK Mahato","year":"2010","unstructured":"Mahato NK (2010) Variable positions of the sacral auricular surface: classification and importance. Neurosurg Focus 28(3):E12","journal-title":"Neurosurg Focus"},{"issue":"12","key":"5604_CR71","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.spinee.2011.11.004","volume":"11","author":"A Urz\u00faa","year":"2011","unstructured":"Urz\u00faa A, Marr\u00e9 B, Mart\u00ednez C et al (2011) Isolated transverse sacral fractures. Spine J 11(12):1117\u20131120","journal-title":"Spine J"},{"issue":"5","key":"5604_CR72","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1227\/00006123-198411000-00021","volume":"15","author":"HH Schmidek","year":"1984","unstructured":"Schmidek HH, Smith DA, Kristiansen TK (1984) Sacral fractures. Neurosurgery 15(5):735\u2013746","journal-title":"Neurosurgery"},{"issue":"12","key":"5604_CR73","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/j.injury.2013.06.023","volume":"44","author":"PM Rommens","year":"2013","unstructured":"Rommens PM, Hofmann A (2013) Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury 44(12):1733\u20131744","journal-title":"Injury"},{"issue":"5","key":"5604_CR74","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00402-020-03546-9","volume":"141","author":"D Krappinger","year":"2021","unstructured":"Krappinger D, Kaser V, Merkel A, Neururer S, Lindtner RA (2021) An alphanumeric classification of osteoporotic pelvic ring injuries. Arch Orthop Trauma Surg 141(5):861\u2013869","journal-title":"Arch Orthop Trauma Surg"},{"issue":"2","key":"5604_CR75","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00005131-199105020-00014","volume":"5","author":"HH Strange-Vognsen","year":"1991","unstructured":"Strange-Vognsen HH, Lebech A (1991) An unusual type of fracture in the upper sacrum. J Orthop Trauma 5(2):200\u2013203","journal-title":"J Orthop Trauma"},{"issue":"7","key":"5604_CR76","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/BOT.0000000000002009","volume":"35","author":"MR Obey","year":"2021","unstructured":"Obey MR, Barnwell J, Routt MLC Jr., Miller AN (2021) Is Sacral Dysmorphism Protective against Spinopelvic Dissociation? Multicenter Case Series. J Orthop Trauma 35(7):366\u2013370","journal-title":"J Orthop Trauma"},{"issue":"7","key":"5604_CR77","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/00005131-199710000-00008","volume":"11","author":"M Oransky","year":"1997","unstructured":"Oransky M, Gasparini G (1997) Associated lumbosacral junction injuries (LSJIs) in pelvic fractures. J Orthop Trauma 11(7):509\u2013512","journal-title":"J Orthop Trauma"},{"issue":"1","key":"5604_CR78","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1148\/radiology.205.1.9314994","volume":"205","author":"A Leone","year":"1997","unstructured":"Leone A, Cerase A, Priolo F, Marano P (1997) Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis. Radiology 205(1):253\u2013259","journal-title":"Radiology"},{"issue":"1","key":"5604_CR79","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s00586-022-07305-9","volume":"32","author":"RM Kanna","year":"2023","unstructured":"Kanna RM, Pratheep KG, Shetty AP, Rajasekaran S (2023) Do all Isler\u2019s type sacral fractures necessarily require surgical fixation? Eur Spine J 32(1):84\u201392","journal-title":"Eur Spine J"},{"issue":"8","key":"5604_CR80","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1177\/21925682221076414","volume":"12","author":"RM Kanna","year":"2022","unstructured":"Kanna RM, Rajasekaran S, Schroeder GD et al (2022) Lumbo-sacral Junction instability by traumatic sacral fractures: Isler\u2019s classification revisited - A narrative review. Global Spine J 12(8):1925\u20131933","journal-title":"Global Spine J"},{"issue":"7","key":"5604_CR81","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1055\/s-0036-1580611","volume":"6","author":"GD Schroeder","year":"2016","unstructured":"Schroeder GD, Kurd MF, Kepler CK et al (2016) The development of a universally accepted sacral fracture classification: a Survey of AOSpine and AOTrauma members. Global Spine J 6(7):686\u2013694","journal-title":"Global Spine J"},{"issue":"Suppl 1","key":"5604_CR82","doi-asserted-by":"crossref","first-page":"S","DOI":"10.1016\/0020-1383(96)83789-2","volume":"27","author":"A G\u00e4nsslen","year":"1996","unstructured":"G\u00e4nsslen A, Pohlemann T, Paul C, Lobenhoffer P, Tscherne H (1996) Epidemiology of pelvic ring injuries. Injury 27(Suppl 1):S\u2013a13","journal-title":"Injury"},{"issue":"4","key":"5604_CR83","doi-asserted-by":"crossref","first-page":"R163","DOI":"10.1186\/cc11487","volume":"16","author":"M Burkhardt","year":"2012","unstructured":"Burkhardt M, Nienaber U, Pizanis A et al (2012) Acute management and outcome of multiple trauma patients with pelvic disruptions. Crit Care 16(4):R163","journal-title":"Crit Care"},{"issue":"8","key":"5604_CR84","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.injury.2012.03.031","volume":"43","author":"BD Figler","year":"2012","unstructured":"Figler BD, Hoffler CE, Reisman W et al (2012) Multi-disciplinary update on pelvic fracture associated bladder and urethral injuries. Injury 43(8):1242\u20131249","journal-title":"Injury"},{"issue":"9","key":"5604_CR85","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1097\/BRS.0b013e3181bb85d0","volume":"35","author":"Y Sugimoto","year":"2010","unstructured":"Sugimoto Y, Ito Y, Tomioka M et al (2010) Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976) 35(9):963\u2013966","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"5604_CR86","first-page":"875","volume":"63","author":"PV Giannoudis","year":"2007","unstructured":"Giannoudis PV, Grotz MR, Tzioupis C et al (2007) Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma 63(4):875\u2013883","journal-title":"J Trauma"},{"issue":"12","key":"5604_CR87","doi-asserted-by":"crossref","first-page":"2803","DOI":"10.2106\/JBJS.H.00598","volume":"91","author":"AK Sathy","year":"2009","unstructured":"Sathy AK, Starr AJ, Smith WR et al (2009) The effect of pelvic fracture on mortality after trauma: an analysis of 63,000 trauma patients. J Bone Joint Surg Am 91(12):2803\u20132810","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"5604_CR88","first-page":"687","volume":"62","author":"K Lunsjo","year":"2007","unstructured":"Lunsjo K, Tadros A, Hauggaard A, Blomgren R, Kopke J, Abu-Zidan FM (2007) Associated injuries and not fracture instability predict mortality in pelvic fractures: a prospective study of 100 patients. J Trauma 62(3):687\u2013691","journal-title":"J Trauma"},{"issue":"10","key":"5604_CR89","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.injury.2011.06.003","volume":"42","author":"BJ Gabbe","year":"2011","unstructured":"Gabbe BJ, de Steiger R, Esser M, Bucknill A, Russ MK, Cameron PA (2011) Predictors of mortality following severe pelvic ring fracture: results of a population-based study. Injury 42(10):985\u2013991","journal-title":"Injury"},{"issue":"8","key":"5604_CR90","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1007\/s11999-012-2276-9","volume":"470","author":"JH Holstein","year":"2012","unstructured":"Holstein JH, Culemann U, Pohlemann T (2012) What are predictors of mortality in patients with pelvic fractures? Clin Orthop Relat Res 470(8):2090\u20132097","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"5604_CR91","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.injury.2011.03.053","volume":"42","author":"T Pohlemann","year":"2011","unstructured":"Pohlemann T, Stengel D, Tosounidis G et al (2011) Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German pelvic trauma Registry Initiative. Injury 42(10):997\u20131002","journal-title":"Injury"},{"issue":"2","key":"5604_CR92","doi-asserted-by":"crossref","first-page":"324","DOI":"10.14444\/8432","volume":"17","author":"AB Rees","year":"2023","unstructured":"Rees AB, Croft AJ, Varas-Rodrguez E, Stephens BF, Abtahi AM (2023) Case Report-traumatic L5-S1 instability: are upright radiographs potentially dangerous? Int J Spine Surg 17(2):324\u2013332","journal-title":"Int J Spine Surg"},{"issue":"20","key":"5604_CR93","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1097\/00007632-199610150-00020","volume":"21","author":"NA Ebraheim","year":"1996","unstructured":"Ebraheim NA, Biyani A, Salpietro B (1996) Zone III fractures of the sacrum. A case report. Spine (Phila Pa 1976) 21(20):2390\u20132396","journal-title":"Spine (Phila Pa 1976)"},{"issue":"8","key":"5604_CR94","first-page":"387","volume":"95","author":"PM Rommens","year":"1992","unstructured":"Rommens PM, Vanderschot PM, Broos PL (1992) Conventional radiography and CT examination of pelvic ring fractures. A comparative study of 90 patients. Unfallchirurg 95(8):387\u2013392","journal-title":"Unfallchirurg"},{"issue":"9","key":"5604_CR95","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1097\/01.brs.0000214940.11096.c8","volume":"31","author":"TR Kuklo","year":"2006","unstructured":"Kuklo TR, Potter BK, Ludwig SC, Anderson PA, Lindsey RW, Vaccaro AR (2006) Radiographic measurement techniques for sacral fractures consensus statement of the Spine Trauma Study Group. Spine 31(9):1047\u20131055","journal-title":"Spine"},{"issue":"9","key":"5604_CR96","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1302\/0301-620X.100B9.BJJ-2018-0071.R1","volume":"100-b","author":"M Winkelmann","year":"2018","unstructured":"Winkelmann M, Lopez Izquierdo M, Clausen JD et al (2018) Fractures of the transverse processes of the fourth and fifth lumbar vertebrae in patients with pelvic ring injuries: indicator of biomechanical instability but not shock. Bone Joint J 100-b(9):1214\u20131219","journal-title":"Bone Joint J"},{"issue":"6","key":"5604_CR97","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.spinee.2013.08.023","volume":"15","author":"SN Dodwad","year":"2015","unstructured":"Dodwad SN, Niedermeier SR, Yu E, Ferguson TA, Klineberg EO, Khan SN (2015) The Morel-Lavall\u00e9e lesion revisited: management in spinopelvic dissociation. Spine J 15(6):e45\u201351","journal-title":"Spine J"},{"issue":"2","key":"5604_CR98","doi-asserted-by":"crossref","first-page":"1","DOI":"10.46292\/sci2702-1","volume":"27","author":"R Rupp","year":"2021","unstructured":"Rupp R, Biering-S\u00f8rensen F, Burns SP et al (2021) International standards for neurological classification of spinal cord Injury: revised 2019. Top Spinal Cord Inj Rehabil 27(2):1\u201322","journal-title":"Top Spinal Cord Inj Rehabil"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-024-05604-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-024-05604-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-024-05604-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T08:21:54Z","timestamp":1767169314000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-024-05604-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":98,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5604"],"URL":"https:\/\/doi.org\/10.1007\/s00402-024-05604-y","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]},"assertion":[{"value":"23 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"37"}}