A. Leone et al., LUMBOSACRAL JUNCTION INJURY ASSOCIATED WITH UNSTABLE PELVIC FRACTURE - CLASSIFICATION AND DIAGNOSIS, Radiology, 205(1), 1997, pp. 253-259
PURPOSE: To determine the types and prevalence of lumbosacral junction
injuries associated with an unstable pelvic fracture and to assess th
e diagnostic value of conventional radiographic and computed tomograph
ic (CT) findings. MATERIALS AND METHODS: Anteroposterior, inlet, and o
utlet radiographs and CT scans in 97 patients with pelvic disruption w
ere retrospectively reviewed. RESULTS: Unstable pelvic fractures were
seen on radiographs in 73 patients, 42 of whom had a sacral fracture.
Fourteen of these 42 patients had an associated L5-S1 facet joint inju
ry (three extraarticular, nine articular, and two complex). In three o
f these 14 patients, the L-5 body was laterally bent by more than 10 d
egrees, with asymmetric L5-S1 intervertebral space. The diagnosis in n
ine of the 14 patients with an associated lumbosacral junction injury
was rendered on the basis of CT findings only. CONCLUSION: Lumbosacral
junction injury must be considered in patients with an unstable pelvi
c fracture, especially in those with an associated sacral fracture. CT
is necessary because these conditions may be overlooked on radiograph
s, although outlet radiographs are better than CT scans for depicting
the possibly associated L5-S1 intervertebral disk lesion.