Stepladder Pattern Transverse Sacral Fracture: A Previously Unreported Morphology With Neurological Recovery.

CASE: A 25-year-old man presented with cauda equina syndrome after a fall from height. Imaging revealed an isolated transverse sacral fracture with contiguous S1 to S4 fracture lines, creating a distinctive "stepladder" morphology without significant canal compromise. The fracture was managed conservatively. Neurological status improved from ASIA Grade C to D, with recovery of perianal sensation and bladder function. At 12 months, the patient demonstrated clinical recovery, with improved functional outcome.

CONCLUSION

This unique "stepladder pattern" transverse sacral fracture demonstrated excellent neurological recovery with conservative management in selected patients without progressive deficits.