Arash Fattahi - MD Neurosurgeon, Department of Neurosurgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abdolhadi Daneshi - MD Neurosurgeon, Department of Neurosurgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Morteza Taheri - MD Neurosurgeon, Department of Neurosurgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Armin Azimi - MD Neurosurgeon, Department of Neurosurgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Traumatic sacral spondylosis is a sporadic injury pattern, and frequently, it is accompanied by injury to the cauda equina with perineal numbness, paralysis of sphincters, and sacral root weakness.Case presentation: A ۳۵-year-old male complained of low back pain, left-sided dropped foot, and sphincter dysfunction after ۹ meters fall. On imaging, he had S۱-S۲ spondylosis. We operated on the patient with a single posterior approach. The L۳-S۳ instrumented fusion after stepwise distraction to reduce deformity concomitant with L۵-S۲ laminectomy and foraminotomy. After two years of follow-up, the sphincter disturbance was relieved, but the limb deficit had no change. On follow-up images, the fusion between S۱ and S۲ was confirmed.Conclusion: We recommend surgical treatment of this injury to allow some neurological improvement and stabilize the spine on the pelvis. Also, the operation must be delayed for days to rule out any intra-pelvic life-threatening, primarily vascular injury. A stepwise intraoperative distraction on not curved rods could be helpful in the reduction of this deformity.

Spondyloptosis, S۱-S۲, Sacral, Instrumentation, Neurological deficit