Sacral insufficiency fractures – a commonl y overlooked cause of low back and pelvic pain; a case report and literature review
Abstract
sacral stress fractures are divided into fatigue fractures and insufficiency fractures. Fatigue fractures occur in a normal bone exposed to abnormal or repetitive stresses, whereas insufficiency fractures occur in weakened bones under normal stress and with no underlying trauma. sacral insufficiency fractures are often overlooked causes of nonspecific lumbosacral back pain, especially in elderly women with underlying osteoporosis. in addition to old age and postmenopausal osteoporosis, other condi-tions which reduce bone mineral density and present risk factors for the occurrence of insufficiency fractures include: long-term glucocorticoid and bisphosphonates therapy, long-term vitamin d insufficiency and osteomalacia, renal osteodystrophy, primary hyperparathyroidism, Paget’s disease, long-term immobilisation and radiotherapy for the treatment of malignant diseases. There are no typical clinical signs to suggest sacral stress fracture. These fractures are often associated with degenerative diseases of the spine and intervertebral disc, and they are often accompanied by pre-existing osteoporotic vertebral compression fractures. Plain radiographs of the spine and pelvis, which are the first step in diagnostic imaging, are usually non-diagnostic when it comes to sacral fractures. due to radicular pain symptoms, magnetic resonance imaging of the lumbosacral spine is the next step in diagnosis, in which sacral fractures are often revealed as accidental findings. in this paper,…
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