OBJECTIVES: To evaluate the effectiveness of transsacral-transiliac screw fixation for the treatment of sacral insufficiency fractures that fail nonoperative treatment. DESIGN: A pilot study series of consecutive patients identified over 5 years were treated and followed prospectively. SETTING: Academic-affiliated, tertiary referral, level 1 trauma center in Dallas, TX. PATIENTS/PARTICIPANTS: Patients were selected on the basis of presenting diagnosis, and failure of nonoperative treatment of their sacral insufficiency fracture. Eleven patients entered to the study, and 10 completed follow-up. INTERVENTION: Placement of transsacral-transiliac screws for sacral insufficiency fracture. MAIN OUTCOME MEASUREMENTS: Comparison of preoperative and postoperative Visual Analog Scale scores and Oswestry Low Back Disability Index scores. RESULTS: Patients experienced statistically significant improvement in both outcome measures after intervention. No complications encountered. CONCLUSIONS: Transsacral-transiliac screw fixation seems to be a safe and effective treatment for sacral insufficiency fractures recalcitrant to nonoperative management. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Sanders et al. (2016) studied this question.