Spinopelvic dissociation: aetiology, presentation and principles of treatment

Spinopelvic dissociation describes the traumatic separation of the axial and appendicular skeleton, commonly involving bilateral vertical sacral fractures which may be linked by a transverse fracture line. This injury may occur in patients with osteoporosis, in which there may be relative stability with minimal displacement; or result from high-energy trauma with extensive associated injuries and an increased risk of complications. Operative intervention forms the mainstay of treatment for high-energy injuries, although the heterogenous nature and relative rarity of this phenomenon renders a comprehensive treatment strategy difficult to define.