{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:42:02Z","timestamp":1787755322620,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We present a case of a 54-year-old man with atraumatic, U-type sacral insufficiency and L5 compression fractures leading to spinopelvic dissociation, inability to ambulate, and bowel\/bladder compromise. The patient underwent L3-4 percutaneous pedicle screw fixation with bilateral iliac bolts and percutaneous iliosacral screw fixation. Postoperatively, the patient had return of bowel\/bladder function and independent ambulation at 2.5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Atraumatic spinopelvic dissociation is an underappreciated pathology in older patients. Here, we describe the result of our preferred treatment strategy, triangular osteosynthesis, to preserve function and independence. Despite optimal, prompt treatment, these injuries pose a difficult rehabilitation process for patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00350","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T16:10:58Z","timestamp":1698941458000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Operative Technique for Sacral Insufficiency Fractures Causing Spinopelvic Dissociation"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0055-4371","authenticated-orcid":false,"given":"Aditya","family":"Muralidharan","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7570-5169","authenticated-orcid":false,"given":"Jenna-Leigh","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-6478","authenticated-orcid":false,"given":"Joshua David","family":"Piche","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3229-9171","authenticated-orcid":false,"given":"Reme Emmanuel","family":"Arhewoh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0771-5493","authenticated-orcid":false,"given":"Mark","family":"Hake","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-6385","authenticated-orcid":false,"given":"Aaron","family":"Perdue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2726-181X","authenticated-orcid":false,"given":"Rakesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-8578","authenticated-orcid":false,"given":"Ilyas","family":"Aleem","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-9987","authenticated-orcid":false,"given":"Jaimo","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10]]},"reference":[{"issue":"4","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/00005131-200105000-00002","article-title":"Percutaneous stabilization of U-shaped sacral fractures using iliosacral screws: technique and early results","volume":"15","author":"Nork","year":"2001","journal-title":"J Orthop Trauma."},{"issue":"9","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1097\/00007632-198511000-00011","article-title":"Transverse fracture of the upper sacrum. Suicidal jumper's fracture","volume":"10","author":"Roy-Camille","year":"1985","journal-title":"Spine (Phila Pa 1976)."},{"issue":"11 suppl","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1097\/01.brs.0000217949.31762.be","article-title":"Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability","volume":"31","author":"Bellabarba","year":"2006","journal-title":"Spine (Phila Pa 1976)."},{"issue":"1","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ocl.2013.08.002","article-title":"Spondylopelvic dissociation","volume":"45","author":"Sullivan","year":"2014","journal-title":"Orthop Clin North Am."},{"issue":"24","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"e1086","DOI":"10.5435\/JAAOS-D-19-00863","article-title":"Spinopelvic dissociation: assessment, reduction strategies, and fixation techniques","volume":"28","author":"Quacinella","year":"2020","journal-title":"J Am Acad Orthop Surg."},{"issue":"1","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.2106\/JBJS.RVW.16.00119","article-title":"Treatment of spinopelvic dissociation: a critical analysis review","volume":"6","author":"Kaye","year":"2018","journal-title":"JBJS Rev."},{"issue":"6","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1017\/S1481803500012732","article-title":"Low-impact pelvic fractures in the emergency department","volume":"12","author":"Dodge","year":"2010","journal-title":"CJEM."},{"issue":"1","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00776-014-0653-9","article-title":"Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature","volume":"20","author":"Rommens","year":"2015","journal-title":"J Orthop Sci."},{"issue":"2","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/15563316211006665","article-title":"Acute neurological deficit due to sacral insufficiency fracture with coexistent severe lumbar canal stenosis: a case report","volume":"18","author":"Garg","year":"2022","journal-title":"HSS J."},{"issue":"6","key":"bib10-20240805","doi-asserted-by":"crossref","first-page":"889","DOI":"10.3171\/jns.1990.72.6.0889","article-title":"Neurological injury and patterns of sacral fractures","volume":"72","author":"Gibbons","year":"1990","journal-title":"J Neurosurg."},{"issue":"1","key":"bib11-20240805","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00586-022-07330-8","article-title":"Treatment of unstable spinopelvic fractures: outcome of three surgical techniques-a retrospective single-center case series","volume":"32","author":"Romoli","year":"2023","journal-title":"Eur Spine J."},{"issue":"12","key":"bib12-20240805","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/BOT.0000000000001308","article-title":"Surgical fixation of geriatric sacral U-type insufficiency fractures: a retrospective analysis","volume":"32","author":"Pulley","year":"2018","journal-title":"J Orthop Trauma."},{"issue":"4","key":"bib13-20240805","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S1297-319X(03)00015-0","article-title":"Mortality and functional outcomes of pelvic insufficiency fractures in older patients","volume":"70","author":"Taillandier","year":"2003","journal-title":"Joint Bone Spine."},{"issue":"7","key":"bib14-20240805","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1111\/j.1532-5415.2011.03455.x","article-title":"Outcomes of displaced and nondisplaced pelvic and sacral fractures in elderly adults","volume":"59","author":"Mears","year":"2011","journal-title":"J Am Geriatr Soc."},{"issue":"2","key":"bib15-20240805","first-page":"560","article-title":"Teriparatide treatment in elderly patients with sacral insufficiency fracture","volume":"102","author":"Yoo","year":"2017","journal-title":"J Clin Endocrinol Metab."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:41:11Z","timestamp":1787751671000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00350"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.23.00350","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}