Bilateral nonunion of the sacrum in a long-term paraplegic patient treated with trans-sacral bar and spinopelvic fixation.

The incidence of fragility fractures of the pelvis is sharply increasing in accordance with growing life expectancy in developed countries. Numerous conditions may compromise bone density and quality, and paraplegia due to spinal cord injury is one of them. As screw anchorage is often problematic in poor bone stock, spinopelvic dissociation demands a type of osteosynthesis, which is less dependent on the density of trabecular bone. We present a case of a paraplegic 45-year-old man, with non-displaced bilateral nonunion of the sacrum. The patient was treated with trans-sacral bar and spinopelvic fixation. Rapid relief from pain and functional recovery was achieved with complete bone healing 1 year after the operation.