Traumatic Sacral Spondyloptosis; Report of an Extremely Rare Case

Traumatic sacral spondylosis is a sporadic injury pattern, and frequently, it is accompanied by injury to the cauda equina with perineal numbness, paralysis of sphincters, and sacral root weakness.

A 35-year-old male complained of low back pain, left-sided dropped foot, and sphincter dysfunction after 9 meters fall. On imaging, he had S1-S2 spondylosis. We operated on the patient with a single posterior approach. The L3-S3 instrumented fusion after stepwise distraction to reduce deformity concomitant with L5-S2 laminectomy and foraminotomy. After two years of follow-up, the sphincter disturbance was relieved, but the limb deficit had no change. On follow-up images, the fusion between S1 and S2 was confirmed.

We recommend surgical treatment of this injury to allow some neurological improvement and stabilize the spine on the pelvis. Also, the operation must be delayed for days to rule out any intra-pelvic life-threatening, primarily vascular injury. A stepwise intraoperative distraction on not curved rods could be helpful in the reduction of this deformity.