Sacral insufficiency fracture surgery complication
Sacral insufficiency fractures are a relatively uncommon complication following lumbosacral instrumented arthrodesis. Risk factors for developing an insufficiency fracture include osteopenia/osteoporosis, increased body mass index, an increased pelvic incidence (PI), and deformity correction and may additionally include surgical technique. Correctly diagnosing an insufficiency fracture can be challenging and requires a high index of suspicion. Diagnosis may be facilitated by lumbosacral computerized tomographic (CT) imaging with coronal reconstructions, as the fracture may be difficult to visualize with axial and sagittal sequences alone. In this chapter, we discuss a case of a postoperative sacral insufficiency fracture, the subsequent surgical treatment of this complication, and recommendations for complication avoidance.