{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:48:17Z","timestamp":1787755697373,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Case:<\/jats:title>\n A 73-year-old man experienced immediate neurological decline after percutaneous transsacral screw fixation for a pelvic ring injury sustained after a 25-foot fall. Workup revealed well-positioned screws and compression of the right L5 and S1 nerve roots at the fracture site. Symptoms improved after direct decompression without screw revision.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The courses of the L5 and S1 nerve roots place them at risk of compression within the fracture during transsacral screw fixation. In highly comminuted fractures, avoidance of compression screws or use of intraoperative CT might prevent this complication. Direct nerve root decompression alone can be a successful treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00638","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T11:54:52Z","timestamp":1596196492000},"page":"e19.00638-e19.00638","source":"Crossref","is-referenced-by-count":0,"title":["Subacute Minimally Invasive Decompression of L5 and S1 Nerve Roots for Neurologic Deficit After Fixation of Unstable Pelvic Fracture"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1272-7093","authenticated-orcid":false,"given":"Shay","family":"Warren","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0284-3397","authenticated-orcid":false,"given":"Michael","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Alamin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"12","key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"656","DOI":"10.5435\/00124635-200611000-00009","article-title":"Sacral fractures","volume":"14","author":"Mehta","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"issue":"375","key":"bib2-20230720","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/00003086-200006000-00004","article-title":"Percutaneous fixation of pelvic ring disruptions","author":"Routt","year":"2000","journal-title":"Clin Orthop Relat Res."},{"issue":"8","key":"bib3-20230720","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.injury.2008.03.024","article-title":"Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures","volume":"39","author":"Schweitzer","year":"2008","journal-title":"Injury."},{"issue":"329","key":"bib4-20230720","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/00003086-199608000-00023","article-title":"Proximity of iliosacral screws to neurovascular structures after internal fixation","author":"Templeman","year":"1996","journal-title":"Clin Orthop Relat Res."},{"issue":"8","key":"bib5-20230720","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1097\/00005131-199711000-00007","article-title":"Iliosacral screw fixation: early complications of the percutaneous technique","volume":"11","author":"Routt","year":"1997","journal-title":"J Orthop Trauma."},{"issue":"2","key":"bib6-20230720","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00005131-199902000-00007","article-title":"Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion","volume":"13","author":"Keating","year":"1999","journal-title":"J Orthop Trauma."},{"issue":"1","key":"bib7-20230720","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/00005373-200207000-00009","article-title":"Fluoroscopic positioning of sacroiliac screws in 88 patients","volume":"53","author":"van den Bosch","year":"2002","journal-title":"J Trauma."},{"issue":"3","key":"bib8-20230720","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/00005131-199506000-00005","article-title":"Early results of percutaneous iliosacral screws placed with the patient in the supine position","volume":"9","author":"Routt","year":"1995","journal-title":"J Orthop Trauma."},{"issue":"11","key":"bib9-20230720","first-page":"513","article-title":"The role of computed tomography for postoperative evaluation of percutaneous sacroiliac screw fixation and description of a \u201csafe zone\u201d","volume":"43","author":"Tejwani","year":"2014","journal-title":"Am J Orthop (Belle Mead, NJ)."},{"key":"bib10-20230720","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00003086-198802000-00010","article-title":"Sacral fractures: an important problem. 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