{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:20:03Z","timestamp":1790918403048,"version":"4.1.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Because patients with advanced cancer live longer, the number of patients with the sequelae of metastatic spine disease has increased. Pathologic instability of the mobile spine has been classified, and minimally invasive surgery has been well described. However, pathologic sacral instability is uncommon and often underdiagnosed. Although most sacral fractures are stable, patients with unstable U- or H-type fractures have spinopelvic dissociation and can experience progressive pain, sacral kyphosis, and neurological injury. Open lumbopelvic fusion carries a high perioperative risk for this patient population, which has often been previously radiated and is medically frail. The authors investigated the utility and safety of percutaneous lumbopelvic fixation, as previously described for traumatic spinopelvic dissociation, in the oncological setting. The authors retrospectively reviewed five consecutive patients with unstable pathologic sacral fractures who had undergone percutaneous lumbopelvic fixation after conservative management failed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>Patients experienced significant improvement between pre- and postoperative visual analog scale scores (9.2 and 1.6, respectively) and Eastern Cooperative Oncology Group grades (median 3 and 1, respectively). All patients were independently ambulatory at the final follow-up. Sagittal alignment remained stable in four patients and worsened in one. There were no major medical or surgical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Percutaneous lumbopelvic fixation shows promising results for palliation, durability, and safety for pathologic sacropelvic instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23205","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T10:10:08Z","timestamp":1691489408000},"source":"Crossref","is-referenced-by-count":3,"title":["Percutaneous lumbopelvic fixation for pathologic sacral fractures and spinopelvic dissociation: patient series"],"prefix":"10.3171","volume":"6","author":[{"given":"Nikolas","family":"Baksh","sequence":"first","affiliation":[{"name":"Department of Surgery, Orthopedic Service, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleb","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Orthopedic Service, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Vaynrub","sequence":"additional","affiliation":[{"name":"Department of Surgery, Orthopedic Service, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"JBJS Rev","first-page":"e8","article-title":"Update on the management of sacral metastases","volume":"6","author":"Mika A","year":"2018","unstructured":"Mika A, Mesfin A. 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Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability. Spine (Phila Pa 1976). 2006;31(11)(suppl):S80\u2013S88, discussion S104.16685241"},{"issue":"7","key":"b16","series-title":"J Orthop Trauma","first-page":"447","article-title":"Decompression and lumbopelvic fixation for sacral fracture-dislocations with spino-pelvic dissociation","volume":"20","author":"Schildhauer TA","year":"2006","unstructured":"Schildhauer TA, Bellabarba C, Nork SE, Barei DP, Routt ML Jr, Chapman JR. Decompression and lumbopelvic fixation for sacral fracture-dislocations with spino-pelvic dissociation. 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J Orthop Trauma. 2006;20(7):447\u2013457.16891935"},{"key":"b17","series-title":"J Orthop","first-page":"75","article-title":"Spinopelvic fixation for vertically unstable AO type C pelvic fractures and sacral fractures with spinopelvic dissociation: a systematic review and pooled analysis involving 479 patients","volume":"29","author":"Patel S","year":"2022","unstructured":"Patel S, Ghosh A, Jindal K, Kumar V, Aggarwal S, Kumar P. Spinopelvic fixation for vertically unstable AO type C pelvic fractures and sacral fractures with spinopelvic dissociation: a systematic review and pooled analysis involving 479 patients. J Orthop. 2022;29:75\u201385.35241881"},{"issue":"9","key":"b18","series-title":"J Orthop Trauma","first-page":"e318","article-title":"Percutaneous lumbopelvic fixation for reduction and stabilization of sacral fractures with spinopelvic dissociation patterns","volume":"30","author":"Williams SK","year":"2016","unstructured":"Williams SK, Quinnan SM. 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