Diagnosis and Management of Spinopelvic Dissociation

Traumatic spinopelvic dissociation (SPD) is a devastating clinical condition that mostly coincides with other major injuries, resulting in worse prognosis and complicated diagnosis (1). In a significant number of cases, the patient needs primary endotracheal intubation that makes the history taking and clinical examination nearly impossible. Therefore, a high index of suspicion should be maintained in any patient with multiple trauma (1). Although the exact epidemiology of SPD is still unknown, previous studies have demonstrated that almost 2.9% of pelvic ring fractures are accompanied by SPD (2). One of the most common mechanisms of injury is falling from a high altitude in suicide victims. Thus, many orthopedists name this injury “suicidal jumper fracture” (3). The diagnosis of SPD is difficult, due to obscurity in routine radiographic views, low incidence, and its coincidence with other traumatic injuries. Given the difficulties in diagnosis and the heterogeneity of its nature, the best way of management is still a topic of debate. This study aims to discuss the main principles and the basis of the management of SPD.