{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:05:09Z","timestamp":1757541909635},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>A traumatically shattered lumbosacral junction\/pelvis may be difficult to repair. Here the authors offer a pelvic fixation technique utilizing routine pedicle screws, interbody lumbar fusions, bilateral iliac screws\/ rods\/crosslinks, and bilateral fibular strut allografts from the lumbar spine to the sacrum.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>A middle aged male sustained a multiple storey fall resulting in a left sacral fracture, and right sacroiliac joint (SI) dislocation. The patient had previously undergone attempted decompressions with routine pedicle screw L4-S1 fusions at outside institutions; these failed twice. When the patient was finally seen, he exhibited, on CT reconstructed images, MR, and X-rays, a left sacral fracture nonunion, and a right sacroiliac joint dislocation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>The patient underwent a bilateral pelvic reconstruction utilizing right L4, L5, S1 and left L4, L5 pedicle screws plus interbody fusions (L4-L5, and L5, S1), performed from the left. Unique to this fusion construct was the placement of bilateral double iliac screws plus the application of bilateral fibula allografts from L4-sacrum filled with bone morphogenetic protein (BMP). After rod\/screw\/connectors were applied, bone graft was placed over the fusion construct, including the decorticated edges of the left sacral fractures, and right SI joint dislocation. We additionally reviewed other pelvic fusion reconstruction methods.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusions: <\/jats:title>\n<jats:p>Here, we utilized a unique pelvic reconstruction technique utilizing pedicle screws\/rods, double iliac screws\/rods, and bilateral fibula strut grafts extending from the L4-sacrum filled with BMP.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_326_2020","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T05:20:36Z","timestamp":1602739236000},"page":"335","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reconstruction of Shattered Lumbo-Sacral Junction\/Pelvis Utilizing Bilateral L4-Sacrum Fibula Strut Allograft And Double Iliac Screws Plus Routine Lumbar Pedicle Screw Fixation"],"prefix":"10.25259","volume":"11","author":[{"given":"Marc","family":"Agulnick","sequence":"first","affiliation":[{"name":"Department of Orthopedics School of Medicine, State University of New York at Stony Brook, NY, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NYU Winthrop Hospital, Mineola, NY, School of Medicine, State University of New York at Stony Brook, NY, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NYU Winthrop Hospital, Mineola, NY, School of Medicine, State University of New York at Stony Brook, NY, USA."},{"name":"Department of Clinical Professor of Neurological Surgery, School of Medicine, State University of New York at Stony Brook, NY, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"issue":"4","key":"10.25259\/SNI_326_2020\/ref-1","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1007\/s00586-015-3976-0","article-title":"Standalone percutaneous transiliac plating of vertically unstable sacral fractures: outcomes complications and recommendations","volume":"25","author":"Ayoub","year":"2016","journal-title":"Eur Spine J"},{"issue":"2","key":"10.25259\/SNI_326_2020\/ref-2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00586-013-3075-z","article-title":"Surgical techniques for spinopelvic reconstruction following total sacrectomy: a systematic review","volume":"23","author":"Bederman","year":"2014","journal-title":"Eur Spine J"},{"issue":"6","key":"10.25259\/SNI_326_2020\/ref-3","doi-asserted-by":"crossref","first-page":"967","DOI":"10.31616\/asj.2018.12.6.967","article-title":"Biomechanical Study of Posterior Pelvic Fixations in Vertically Unstable Sacral Fractures: An Alternative to Triangular Osteosynthesis","volume":"12","author":"Chaiyamongkol","year":"2018","journal-title":"Asian Spine J"},{"issue":"2","key":"10.25259\/SNI_326_2020\/ref-4","first-page":"5","article-title":"Posterior Reconstruction of Vertebral Body using Expandable Cage for L5 Burst Fracture Dislocation: Case Report","volume":"4","author":"Padalkar","year":"2014","journal-title":"J Orthop Case Rep"},{"key":"10.25259\/SNI_326_2020\/ref-5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.wneu.2019.07.050","article-title":"Traumatic Sacral Fractures: Navigation Technique in Instrumented Stabilization","volume":"131","author":"Santoro","year":"2019","journal-title":"World Neurosurg"},{"issue":"10","key":"10.25259\/SNI_326_2020\/ref-6","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1007\/s00402-019-03204-9","article-title":"Space available for trans-sacral implants to treat fractures of the pelvis assessed by virtual implant positioning","volume":"139","author":"Wagner","year":"2019","journal-title":"Arch Orthop Trauma Surg"},{"issue":"7","key":"10.25259\/SNI_326_2020\/ref-7","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1302\/0301-620X.101B7.BJJ-2018-1010.R2","article-title":"Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacralendoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study","volume":"101-B","author":"Wei","year":"2019","journal-title":"Bone Joint J"},{"issue":"6","key":"10.25259\/SNI_326_2020\/ref-8","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1111\/os.12563","article-title":"En Bloc Resection and Pelvic Ring Reconstruction for Primary Malignant Bone Tumors Involving Sacroiliac Joint","volume":"11","author":"Xu","year":"2019","journal-title":"Orthop Surg"}],"container-title":["Surgical Neurology 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