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Managing TLSI and its four underlying conditions poses unique challenges among spinal and pelvic injuries. This second part of a two-part series focuses on treatment strategies and decision making in TLSI, with an emphasis on surgical stabilization techniques. The primary objectives of this article are to: (1) elucidate factors influencing clinical decision-making, (2) synthesize current treatment options for the injury patterns underlying TLSI, and (3) briefly outline expected outcomes and complications.<\/jats:p>","DOI":"10.1007\/s00402-025-05752-9","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T09:33:34Z","timestamp":1738402414000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Traumatic lumbosacral instability: part 2\u2014indications and techniques for surgical management"],"prefix":"10.1007","volume":"145","author":[{"given":"Richard A.","family":"Lindtner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Krappinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Lindahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Bellabarba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,1]]},"reference":[{"issue":"1","key":"5752_CR1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00402-024-05604-y","volume":"145","author":"RA Lindtner","year":"2024","unstructured":"Lindtner RA, Krappinger D, Lindahl J, Bellabarba C (2024) Traumatic lumbosacral instability: part 1 - proposing a definition and identifying underlying injury patterns. 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