A Rare Presentation of Bilateral Lumbosacral Dislocation with Fracture of the Sacrum – Comprehensive Literature Review
Shahzaib Riaz Baloch1*, Mohammad Sohail Rafi1, Zardana Riaz2, Saoud Javed1
1Department of Orthopaedics and Spine Surgery, Dr. Ziauddin Hospital, Clifton, Karachi Pakistan.
2Department of Biochemistry, Bolan University of Medical & Health Sciences, Quetta Pakistan.
*Corresponding Author: Shahzaib Riaz Baloch, Department of Orthopaedics and Spine Surgery, Dr. Ziauddin Hospital, Clifton, Karachi Pakistan. ORCID: 0009-0003-1741 228X,
https://doi.org/10.58624/SVOAOR.2025.05.022
Received: November 24, 2025
Published: December 17, 2025
Citation: Baloch SR, Rafi MS, Riaz Z, Javed S. Effectiveness A Rare Presentation of Bilateral Lumbosacral Dislocation with Fracture of the Sacrum – Comprehensive Literature Review. SVOA Orthopaedics 2025, 5:6, 134-141. doi: 10.58624/SVOAOR.2025.05.022
Abstract
Introduction: The lumbar vertebrae facet joint dislocation is typically brought on by high-energy trauma. There is a paucity of literature on the dislocation of Lumbar vertebrae, with most published studies being infrequent case reports. Compared to the cervical spine, the lumbar spine's facet joints are more coronal in orientation, the coronal position increases stability and restricts the range of motion, which lowers the risk of dislocation. Additional stability is provided to the lumbar spine by huge, robust muscles and robust ligaments. These features cumulatively reduce the likelihood of dislocation
Case Presentation: A 25-year-old male presented to the emergency room following a motor vehicle accident (MVA). An evaluation revealed bilateral L5-S1dislocation, Femur shaft closed fracture, Sacral fracture along with bilateral superior Pubic rami fractures. Owing to the injury's intricacy, a staged surgery was planned. Emergency surgery was performed on the day of admission involving the debridement and repair of the perianal wound along with closed intramedullary nailing of the Femur. On the second post-operative day, the second procedure was performed: percutaneous fixation of the Sacrum followed by posterior decompression of L5-S1, extraction of the sequestered disc, posterior stabilization of L4 to S1 + S2 AI screws, and interbody fusion of L5-S1 along with autologous bone grafting (using the decompressed bone) for 360-fusion using the posterior only approach.
Conclusion: Bilateral facet dislocation of the L5-S1 is a rare injury, and therefore worth reporting. Multidisciplinary approach, timely diagnosis, can lead to successful management of such complicated injuries.
Keywords: Lumbar Dislocation, Traumatic Spine Injury, Sacrum Fracture, Interbody Fusion, Spinal Stabilization.