Published online Jan 18, 2016. doi: 10.5312/wjo.v7.i1.69
Peer-review started: January 2, 2015
First decision: January 20, 2015
Revised: June 28, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: January 18, 2016
Core tip: Sacral fractures following posterior lumbosacral fusion are rare. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion.