PELVIC INSUFFICIENCY: UNDERDIAGNOSED CONDITION, THERAPEUTIC DIAGNOSTIC REVIEW

• Main Authors: Francisco Javier Sánchez García, Jorge Alberto de Haro Estrada, Herman Michael Dittmar Johnson
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Coluna (SBC)
• Series: Coluna/Columna
• Subjects: Fractura; Pelvis; Diagnóstico; Terapéutica
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000200151&lng=en&tlng=en

ABSTRACT Objective: The importance of sacral fractures has recently been recognized. However, its diagnosis is difficult, both clinically and through image, but there are more options for comprehensive diagnosis. Methods: We conducted a literature review about its diagnosis and the treatments currently offered, and also to check which treatments had the best results. Results: Patients with pelvic insufficiency have limited mobility due to lumbar or pelvic pain. As radiculopathy is a neurologically stable condition, it has a reported incidence of only 5% and sphincter disorders. The pain improves when lying down and increases with load. The treatments vary from conservative to surgical. Discussion: The different treatments were compared, and the one that has more morbidity is the conservative, because it predisposes us to complications (pneumonia, pulmonary embolism, deep vein thrombosis, heart failure, decubitus ulcers); in the interventionists we observe a faster improvement to normal activity of these patients, the complications are minor and the pain improvement is noticeable and much faster. Conclusion: Fractures due to pelvic insufficiency are underdiagnosed. However, there are already better imaging techniques and combined with good exploration and clinical history we can suspect this condition and offer the best possible treatment, these being the invasive ones that have had better results with lower morbidity and recovery of activity much more quickly. Level of Evidence III; Review of therapeutic studies - Investigation of treatment results.