Sacral insufficiency fracture surgically treated by fibular allograft

A. Jay Khanna, Khaled M. Kebaish, H. Mustafa Ozdemir, David B. Cohen, Ricardo A. Gonzales, John P. Kostuik

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Sacral insufficiency fractures have been known to occur distally after long instrumentation to the sacrum. Most such fractures are treated nonoperatively, but surgery is indicated for patients who have nonunions, persistent pain, neurologic deficits, or gross displacement. The current report elucidates the potential complication of sacral fracture after long lumbar arthrodesis, reviews the pertinent literature, presents three patients with sacral fractures after long instrumented lumbar spinal arthrodesis to the sacrum, and describes a new surgical technique for stabilizing such fractures. One patient was treated nonoperatively, and two patients were treated with arthrodesis from a posterior approach and augmentation with a strut fibular allograft. All three patients were followed to radiographic and clinical union. The authors conclude that sacral fracture is a potential complication after a long lumbar arthrodesis. Nonoperative techniques are often successful, but when they are not, a new technique using fibular allografts can be successful.

Original languageEnglish (US)
Pages (from-to)167-173
Number of pages7
JournalJournal of Spinal Disorders and Techniques
Issue number3
StatePublished - Jun 2004


  • Allograft
  • Fibula
  • Lumbosacral fusion
  • Sacral fracture
  • Sacral nonunion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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