A new minimally invasive U-shaped lumbopelvic stabilization technique

  • Sebastian DeckerEmail author
  • Jonas Herden
  • Christian Krettek
  • Christian W. Müller
Original Article • PELVIS - FRACTURES


Lumbopelvic stabilization is a surgical technique used frequently to treat lumbosacral fractures; however, it can also be used in revision cases, infections, or during deformity correction. However, the related soft tissue complication rates associated with open lumbopelvic stabilization are high. Different authors have recently reported minimally invasive surgical techniques. We developed a rigid minimally invasive technique for lumbopelvic stabilization. We present our technique and also present preliminary results from 10 cases. We did not observe soft tissue-related complications in any patient. Implant removal was performed twice, to release healthy disks and because of implant prominence. One patient required revision surgery because of implant loosening due to osteoporosis, and one patient required revision surgery due to screw cap loosening. Postsurgical mobilization was good in all patients without further injuries; however, polytraumatized patients were limited by additional injuries. Thus, minimally invasive U-shaped lumbopelvic stabilization is a useful technique combining the soft tissue-related advantages of minimally invasive surgical techniques as well as a theoretically very rigid construct caused by strong implants.


Lumbopelvic stabilization Trauma Sacral fracture Wound healing Infection Surgical technique 


Compliance with ethical standards

Conflict of interest

Authors declare that they do not have any conflict of interest.

Ethical statements

This study complies with current law in Germany and was approved by the local ethics committee (No. 2479-2014).


  1. 1.
    Schildhauer TA, Josten C, Muhr G (1998) Triangular osteosynthesis of vertically unstable sacrum fractures: a new concept allowing early weight-bearing. J Orthop Trauma 12(5):307–314CrossRefGoogle Scholar
  2. 2.
    Schildhauer TA, Ledoux WR, Chapman JR, Henley MB, Tencer AF, Routt ML Jr (2003) Triangular osteosynthesis and iliosacral screw fixation for unstable sacral fractures: a cadaveric and biomechanical evaluation under cyclic loads. J Orthop Trauma 17(1):22–31CrossRefGoogle Scholar
  3. 3.
    Roetman B, Schildhauer TA (2013) Lumbopelvic stabilization for bilateral lumbosacral instabilities: indications and techniques. Unfallchirurg 116(11):991–999CrossRefGoogle Scholar
  4. 4.
    Kach K, Trentz O (1994) Distraction spondylodesis of the sacrum in “vertical shear lesions” of the pelvis. Unfallchirurg 97(1):28–38Google Scholar
  5. 5.
    Bellabarba C, Schildhauer TA, Vaccaro AR, Chapman JR (2006) Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability. Spine (Phila Pa 1976) 31(11 Suppl):S80–S88 (discussion S104) CrossRefGoogle Scholar
  6. 6.
    Beck M, Krober M, Mittlmeier T (2010) Intraoperative three-dimensional fluoroscopy assessment of iliosacral screws and lumbopelvic implants stabilizing fractures of the os sacrum. Arch Orthop Trauma Surg 130(11):1363–1369CrossRefGoogle Scholar
  7. 7.
    Tian W, Chen WH, Jia J (2018) Traumatic spino-pelvic dissociation with bilateral triangular fixation. Orthop Surg 10(3):205–211CrossRefGoogle Scholar
  8. 8.
    Keel MJ, Benneker LM, Siebenrock KA, Bastian JD (2011) Less invasive lumbopelvic stabilization of posterior pelvic ring instability: technique and preliminary results. J Trauma 71(3):E62–E70Google Scholar
  9. 9.
    Williams SK, Quinnan SM (2016) Percutaneous lumbopelvic fixation for reduction and stabilization of sacral fractures with spinopelvic dissociation patterns. J Orthop Trauma 30(9):e318–e324CrossRefGoogle Scholar
  10. 10.
    Yano S, Aoki Y, Watanabe A, Nakajima T, Takazawa M, Hirasawa H, Takahashi K, Nakagawa K, Nakajima A, Takahashi H, Orita S, Eguchi Y, Suzuki T, Ohtori S (2017) Less invasive lumbopelvic fixation technique using a percutaneous pedicle screw system for unstable pelvic ring fracture in a patient with severe multiple traumas. J Neurosurg Spine 26(2):203–207CrossRefGoogle Scholar
  11. 11.
    Hasan MY, Liu G (2017) Minimally invasive dual iliac screw, dual rod fixation in a rare case of pathological sacral fracture from a paraganglionoma: a technique description. J Neurosurg Spine 27(3):316–320CrossRefGoogle Scholar
  12. 12.
    Wilke HJ, Fischer K, Jeanneret B, Claes L, Magerl F (1997) In vivo measurement of 3-dimensional movement of the iliosacral joint. Z Orthop Ihre Grenzgeb 135(6):550–556CrossRefGoogle Scholar
  13. 13.
    Drazin D, Hussain M, Harris J, Hao J, Phillips M, Kim TT, Johnson JP, Bucklen B (2015) The role of sacral slope in lumbosacral fusion: a biomechanical study. J Neurosurg Spine 23(6):754–762CrossRefGoogle Scholar
  14. 14.
    Fuchtmeier B, Maghsudi M, Neumann C, Hente R, Roll C, Nerlich M (2004) The minimally invasive stabilization of the dorsal pelvic ring with the transiliacal internal fixator (TIFI)–surgical technique and first clinical findings. Unfallchirurg 107(12):1142–1151CrossRefGoogle Scholar
  15. 15.
    Denis F, Davis S, Comfort T (1988) Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 227:67–81Google Scholar
  16. 16.
    Roy-Camille R, Saillant G, Gagna G, Mazel C (1985) Transverse fracture of the upper sacrum. Suicidal jumper’s fracture. Spine (Phila Pa 1976) 10(9):838–845CrossRefGoogle Scholar
  17. 17.
    Phan K, Rao PJ, Mobbs RJ (2015) Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: systematic review and meta-analysis of comparative studies. Clin Neurol Neurosurg 135:85–92CrossRefGoogle Scholar
  18. 18.
    Herren C, Reijnen M, Pishnamaz M, Lichte P, Andruszkow H, Nebelung S, Siewe J, Hildebrand F, Kobbe P (2018) Incidence and risk factors for facet joint violation in open versus minimally invasive procedures during pedicle screw placement in patients with trauma. World Neurosurg 112:e711–e718CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Trauma DepartmentHannover Medical SchoolHannoverGermany
  2. 2.Department for Orthopaedics and TraumaAsklepios Klinik WandsbekHamburgGermany

Personalised recommendations