Intracanal Sacral Nerve Impingement Following Percutaneous Iliosacral Screw Pelvic Fixation

Percutaneous iliosacral screws are useful in treating vertical posterior pelvic fractures and iliosacral disruptions. Iliosacral screws are far less invasive than spinopelvic fixation, and result in much lower morbidity. However, safe placement of the iliosacral screws is technically difficult and highly dependent on fracture reduction and adequate fluoroscopy. Inaccurate placement can result in neurological impingement or injury, most commonly involving the L5 nerve root as it traverses the anterior sacrum. This report reviews the evaluation and management of a case in which impingement on the spinal canal and sacral nerves occurred following percutaneous iliosacral screw fixation of an unstable pelvic fracture. The patient was informed that data concerning the case would be submitted for publication, and she provided consent.