{"id":9486,"date":"2026-10-23T06:00:00","date_gmt":"2026-10-23T04:00:00","guid":{"rendered":"https:\/\/complexspineinstitute.com\/sin-categoria\/sacral-fragility-fracture-signs-diagnosis\/"},"modified":"2026-10-23T06:06:56","modified_gmt":"2026-10-23T04:06:56","slug":"sacral-fragility-fracture-signs-diagnosis","status":"publish","type":"post","link":"https:\/\/complexspineinstitute.com\/en\/neurosurgery-blog\/sacral-fragility-fracture-signs-diagnosis\/","title":{"rendered":"Sacral fragility fracture: signs and diagnosis"},"content":{"rendered":"<p style=\"margin-bottom:16px;line-height:1.7\"><strong>Sacral fragility fracture is an underdiagnosed cause of pain at the base of the back, especially in older people with osteoporosis or reduced bone strength. It is often disguised as low back pain, sacroiliac pain or even sciatica, so the problem is not only the pain but that the clinical picture does not fit a muscle contracture or an ordinary \u201clumbago.\u201d Suspecting it in time changes the diagnostic approach, avoids low-yield tests and helps prevent complications from immobility.<\/strong><\/p>\n<ul style=\"margin-bottom:16px;line-height:1.7\">\n<li>Sacral fractures can be missed on plain radiographs.<\/li>\n<li>They usually occur in older people with osteoporosis or bone fragility.<\/li>\n<li>Pain can be located in the sacrum, buttock or lower lumbar area.<\/li>\n<li>Walking, turning or rising from a chair may worsen it.<\/li>\n<li>MRI and CT are key to confirming the diagnosis.<\/li>\n<li>Treatment is usually conservative, but some cases require stabilization.<\/li>\n<li>If neurological or sphincter symptoms appear, urgent evaluation is required.<\/li>\n<\/ul>\n<h2 id=\"que-es-y-por-que-ocurre\" style=\"margin-top:32px;margin-bottom:12px\">What it is and why it happens<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">A <strong>sacral fracture<\/strong> is a break of the sacrum, the triangular bone at the base of the spine, between the last lumbar vertebra and the coccyx. When we speak of a <strong>sacral fragility fracture<\/strong> we refer to an injury that appears in a bone weakened by osteoporosis, bone loss or other factors that reduce its strength. A major trauma is not necessary for it to occur: sometimes a twist, a minor fall or even no clear trigger at all is enough.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">This type of fracture belongs to the group of <strong>insufficiency fractures<\/strong>, that is, injuries produced because the bone cannot withstand normal everyday loads. In older patients, the combination of fragile bone, unsteady gait, loss of balance and persistent pain favors the sacrum developing a crack without a notable preceding injury. Therefore, when the pain \u201cdoesn\u2019t fit\u201d a simple low back pain, sacral fracture should be included in the differential diagnosis.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">The medical literature describes these fractures as frequently underdiagnosed because their symptoms are vague and can seem like a muscular problem, a painful sacroiliac joint, lumbar radiculopathy or bone metastasis. In addition, osteoporosis often reduces the visibility of the injury on the initial X-ray. In practical terms, this means that low back pain that worsens on standing or walking in a person with bone fragility should not be automatically assumed to be just \u201cwear-and-tear\u201d or a \u201cmuscle strain.\u201d<\/p>\n<h2 id=\"sintomas-y-senales-de-alarma\" style=\"margin-top:32px;margin-bottom:12px\">Symptoms and warning signs<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">The main symptom of a <strong>sacral fracture<\/strong> is pain. It is usually a deep, poorly localized pain in the sacral, gluteal or lumbosacral area. It can start relatively suddenly or develop progressively. Many people describe it as a pain that does not fit typical mechanical low back pain: it does not improve as expected with relative rest, recurs when trying to walk and is disproportionate to what seems like a minor effort.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">The features that most strongly suggest a sacral fragility fracture are:<\/p>\n<ul style=\"margin-bottom:16px;line-height:1.7\">\n<li>Pain in the sacrum, buttock or lower lumbar region without a significant trauma.<\/li>\n<li>Worsening with walking, turning in bed or rising from a chair.<\/li>\n<li>Pain on bearing weight, with relative relief when sitting or lying down.<\/li>\n<li>Difficulty walking, short steps or need for additional assistance.<\/li>\n<li>Pain that can be mistaken for sciatica but without a clear radicular pattern.<\/li>\n<li>History of osteoporosis, previous fractures or prolonged corticosteroid therapy.<\/li>\n<li>Pain that persists despite usual treatment for low back pain.<\/li>\n<\/ul>\n<p style=\"margin-bottom:16px;line-height:1.7\">There are also situations that require raising the level of concern. The appearance of a <strong>neurological deficit<\/strong> \u2014for example, leg weakness, progressive numbness or sensory changes in the perineal area\u2014 is not expected in a stable sacral fracture and requires urgent evaluation. The same applies if changes in bladder or bowel control occur, because a sacral fracture can, in less frequent cases, be associated with neurological involvement or a more complex clinical picture.<\/p>\n<h2 id=\"como-se-diagnostica\" style=\"margin-top:32px;margin-bottom:12px\">How it is diagnosed: imaging tests and examination<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">The diagnosis of a <strong>sacral fracture<\/strong> begins with a thorough clinical history. It is important to ask about age, known bone density, recent falls even if they seemed trivial, pain when walking, corticosteroid treatment, history of radiotherapy, previous fractures and bone pain at other sites. Physical examination may show tenderness on palpation of the sacrum, pain on weight bearing or functional limitation, although findings are not always striking.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">The major difficulty is that plain radiographs can be normal or inconclusive. This does not rule out the lesion. In fact, in patients with osteoporosis, the sensitivity of X-ray to detect sacral fractures can be very low. Therefore, if clinical suspicion is reasonable, one should proceed to more sensitive imaging techniques.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">Magnetic resonance imaging (<strong>MRI<\/strong>), which is an imaging test that uses magnetic fields and not ionizing radiation, is usually the most sensitive technique to detect bone edema, occult fracture lines and early changes. Computed tomography (<strong>CT<\/strong>) provides detailed bone cuts and is very helpful in defining fracture morphology, assessing displacement and excluding other causes such as tumor or infection. In some cases, a bone scan can also provide information, although it is used less frequently as a first option today.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">The choice between MRI and CT depends on the clinical context and availability, but the practical message is clear: if the pain does not fit a banal low back pain, advanced imaging is often necessary. Additionally, when the sacral fracture appears to be part of a fragile pelvic ring, it is useful to consider the integrity of the entire pelvic ring and not only the isolated sacrum.<\/p>\n<h2 id=\"alternativas-de-tratamiento-no-quirurgicas\" style=\"margin-top:32px;margin-bottom:12px\">Non-surgical treatment options<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">Most <strong>sacral fragility fractures<\/strong> are initially managed without surgery, provided there is no significant displacement, marked instability or important neurological symptoms. The goal is to control pain, maintain safe mobility and avoid the vicious cycle of prolonged rest, muscle loss and increased dependence.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">Conservative measures usually include scheduled analgesia adjusted to pain intensity, progressive mobilization, support with assistive devices if needed, and correction of factors that have promoted bone fragility. In people with osteoporosis, treatment for bone health is essential to reduce the risk of new fractures. A rehabilitation program aimed at restoring gait, balance and functional confidence can also be helpful, always adapted to pain and the stability of the case.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">In some situations partial offloading or limiting certain activities for a time is recommended, but prolonged absolute rest is usually counterproductive. Immobility favors thrombosis, muscle mass loss, constipation, deterioration of general condition and increased fall risk. Therefore, even with a painful sacral fracture, the strategy is usually to find a balance between protection and early supervised mobility.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">When pain is persistent but there is no evidence of severe instability, non-surgical treatment can be sufficient. However, if recovery stagnates, if pain prevents walking despite correct management, or if imaging shows a complex lesion, the plan should be reconsidered. A sacral fracture should not be treated as a simple chronic low back pain if the clinical pattern does not fit.<\/p>\n<h2 id=\"alternativas-quirurgicas\" style=\"margin-top:32px;margin-bottom:12px\">Surgical options<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">Surgery is not necessary for all <strong>sacral fractures<\/strong>, but it can be useful when pain is disabling, stability is compromised or there is neurological involvement. The least invasive option in selected cases is <strong>sacroplasty<\/strong>, a percutaneous procedure in which bone cement is injected into the fractured area to stabilize it and reduce pain from micromotion. It is not a universal solution, but it can provide relief in selected patients.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">If the fracture is part of a more unstable pelvic pattern or there is significant displacement, broader fixation with screws or sacropelvic stabilization systems may be required. In complex situations, especially when associated with other fractures or prior spine surgery, the surgical plan must be carefully individualized. The sacrum does not behave like an isolated lumbar vertebra: its biomechanics are tied to the pelvis and the posterior ring, so the operative strategy varies according to the injury type.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">Surgical decision-making is usually reserved for specific cases: refractory pain, persistent functional incapacity, unstable fracture, progression of the lesion or neurological compromise. In other words, surgery is not decided by the diagnostic label alone but by the combination of pain, stability, ability to mobilize and the risk of complications if a conservative approach is maintained.<\/p>\n<h2 id=\"beneficios-riesgos-y-efectos-adversos\" style=\"margin-top:32px;margin-bottom:12px\">Benefits, risks and adverse effects<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">The main benefit of accurately diagnosing a <strong>sacral fragility fracture<\/strong> is avoiding that the patient becomes trapped in an incorrect diagnosis of low back pain, sacroiliac pain or sciatica. An accurate diagnosis allows treating the bone, protecting mobility and reducing unnecessary time in pain. It also helps detect previously unrecognized osteoporosis and prevent new fractures, which in this context are a sign of systemic fragility.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">Conservative treatment carries fewer risks than surgery, but it is not free of problems: persistent pain, slow recovery and complications related to immobility if the patient is not mobilized properly. Sacroplasty and other surgical techniques can offer faster relief in selected patients, although they carry risks such as bleeding, infection, cement leakage, fixation failure or residual pain.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">It is also important to remember that not all pain that coincides with a sacral fracture is due solely to the fracture. Lumbar osteoarthritis, stenosis, painful sacroiliac joint or a more widespread bone problem can coexist. Therefore, the real benefit is not to \u201coperate more,\u201d but to choose the correct strategy with a comprehensive clinical interpretation.<\/p>\n<h2 id=\"criterios-de-derivacion-al-especialista\" style=\"margin-top:32px;margin-bottom:12px\">Referral criteria to a specialist<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">Referral to a spine specialist, orthopedics or neurosurgery is advisable when the suspicion of a <strong>sacral fracture<\/strong> is high and initial imaging does not clarify the case, when pain prevents walking or when there are diagnostic doubts with tumor, infection or complex pelvic fracture. Early referral should also be considered if the patient has significant osteoporosis, multiple fragility fractures or pain that does not improve within a reasonable time despite correct management.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">There are situations in which referral should not be delayed: leg weakness, loss of perineal sensation, changes in sphincter control, very intense pain that forces bed rest, or a fracture suspected of instability. In older people, waiting too long can worsen functional status and make recovery more difficult. A sacral fracture is not always a surgical emergency, but it can become a serious problem if minimized.<\/p>\n<h2 id=\"tiempos-de-recuperacion-realistas\" style=\"margin-top:32px;margin-bottom:12px\">Realistic recovery times<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">Recovery times for a <strong>sacral fracture<\/strong> are variable and depend on fracture stability, underlying bone status, age and the ability to mobilize without worsening pain. In conservative cases, pain may decrease gradually over several weeks, but full functional improvement often takes longer. The bone needs time to heal, and recovery of safe gait usually lags behind improvement of resting pain.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">After sacroplasty, some patients notice relief earlier than with purely conservative management, although responses are not identical in all cases. If the fracture is part of a more fragile pelvis or if there is significant deconditioning, return to usual mobility can be considerably prolonged. The important point is not to compare this injury with a brief episode of low back pain: a sacral fracture may require a longer, planned recovery process.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">A common mistake is to think that residual pain means treatment failure. In reality, recovery is often staged: first the sharpest pain decreases, then tolerance to standing improves and finally gait and endurance normalize. Rehabilitation and osteoporosis treatment directly influence that course.<\/p>\n<h2 id=\"cuando-acudir-a-urgencias\" style=\"margin-top:32px;margin-bottom:12px\">When to seek emergency care<\/h2>\n<p style=\"margin-bottom:16px;line-height:1.7\">Any suspected <strong>sacral fracture<\/strong> should be evaluated in the emergency department if there is a sudden inability to walk, unbearable pain, neurological worsening or signs of bladder or bowel involvement. It is also important to seek prompt care after a significant fall, if the pain is accompanied by fever, or if there is a history of cancer suggesting a pathological fracture or a more serious cause.<\/p>\n<p style=\"margin-bottom:16px;line-height:1.7\">Urgency is especially relevant when the pain no longer resembles routine low back pain and there is also weakness, progressive numbness, loss of genital sensitivity or difficulty urinating or defecating. In these cases it is not enough to wait and see if it improves. Even if a sacral fragility fracture is the final explanation, these symptoms require exclusion of neurological complications or associated pathology.<\/p>\n<h2 id=\"mitos-y-realidades\" style=\"margin-top:32px;margin-bottom:12px\">Myths and realities<\/h2>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Myth: \u201cIf there was no hard fall, it cannot be a fracture\u201d<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Reality: <strong>sacral fragility fracture<\/strong> can appear after a minor effort or even without a clear trauma, especially in people with osteoporosis.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Myth: \u201cIf the X-ray is normal, there is nothing important\u201d<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Reality: plain radiographs can miss many sacral fractures. If clinical suspicion is high, more sensitive tests like MRI or CT are needed.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Myth: \u201cEvery sacral fracture needs surgery\u201d<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Reality: most are treated without surgery. Intervention is reserved for selected cases with refractory pain, instability or neurological involvement.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Myth: \u201cIf it hurts in the buttock, it must be sciatica\u201d<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Reality: buttock pain can also come from the sacrum, pelvis or sacroiliac joint. Pain distribution alone is not enough to label it sciatica.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Myth: \u201cAbsolute rest is the best solution\u201d<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Reality: prolonged rest usually worsens fragility, muscle loss and functional recovery. The usual approach is to seek safe, progressive mobilization.<\/p>\n<h2 id=\"preguntas-frecuentes\" style=\"margin-top:32px;margin-bottom:12px\">Frequently asked questions<\/h2>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Does a sacral fracture cause low back pain or buttock pain?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">It can cause both. Often the pain is perceived in the lower lumbar area, the sacrum or the buttock, which is why it is confused with low back pain or a sacroiliac problem.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">What is the difference between low back pain and a sacral fracture?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Low back pain is a broad term for back pain. A sacral fracture is a specific cause of pain at the base of the spine, mainly in older people with bone fragility, and it typically worsens with weight bearing.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Can it be seen on a plain radiograph?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Sometimes yes, but often no. X-rays can be normal even with a true sacral fracture, so they are insufficient to rule it out if clinical suspicion is high.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Which test best confirms a sacral fracture?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">MRI is usually the most sensitive to detect occult fractures and bone edema. CT is very helpful to define the lesion\u2019s anatomy and to exclude other causes.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Is hospital admission always necessary?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Not always. It depends on pain, the ability to walk, fracture stability and whether there are neurological symptoms or problems controlling sphincters.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Does osteoporosis increase the risk?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Yes. Osteoporosis is one of the most important risk factors because it reduces bone strength and facilitates fragility fractures of the sacrum and pelvis.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">How long does it take to improve?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Improvement is usually gradual and may require weeks. Exact timing depends on fracture stability, initial pain, age and the patient\u2019s overall condition.<\/p>\n<h3 style=\"margin-top:24px;margin-bottom:8px\">Can a sacral fracture be mistaken for sciatica?<\/h3>\n<p style=\"margin-bottom:16px;line-height:1.7\">Yes, and often. Pain can radiate or be felt in the buttock and resemble sciatica, but the typical neurological distribution is not always present.<\/p>\n<h2 id=\"glosario\" style=\"margin-top:32px;margin-bottom:12px\">Glossary of medical terms<\/h2>\n<ul style=\"margin-bottom:16px;line-height:1.7\">\n<li><strong>Sacrum:<\/strong> the triangular bone at the base of the spine, between the lumbar spine and the coccyx.<\/li>\n<li><strong>Fragility fracture:<\/strong> a bone break that occurs with minimal trauma because the bone is weakened.<\/li>\n<li><strong>Bone insufficiency:<\/strong> the inability of bone to withstand normal loads without being injured.<\/li>\n<li><strong>Osteoporosis:<\/strong> a disease that reduces bone density and quality, increasing fracture risk.<\/li>\n<li><strong>Magnetic resonance imaging (MRI):<\/strong> an imaging test that uses magnetic fields to show soft tissues and bone edema in detail.<\/li>\n<li><strong>CT:<\/strong> computed tomography, an X-ray test that provides detailed cross-sectional images of bone.<\/li>\n<li><strong>Bone edema:<\/strong> accumulation of fluid within the bone that usually indicates a recent injury.<\/li>\n<li><strong>Sacroplasty:<\/strong> a percutaneous procedure to stabilize a sacral fracture by injecting bone cement.<\/li>\n<li><strong>Neurological deficit:<\/strong> loss of strength, sensation or nervous function due to nervous system involvement.<\/li>\n<li><strong>Sacroiliac joint:<\/strong> the joint between the sacrum and the ilium of the pelvis, which can also be a source of pain and confuse the diagnosis.<\/li>\n<\/ul>\n<h2 id=\"referencias\" style=\"margin-top:32px;margin-bottom:12px\">References<\/h2>\n<ul style=\"margin-bottom:16px;line-height:1.7\">\n<li><a href=\"https:\/\/www.aans.org\/patients\/conditions-treatments\/low-back-pain\/\" target=\"_blank\" rel=\"noopener\">AANS. Low Back Pain. 2023<\/a><\/li>\n<li><a href=\"https:\/\/www.aans.org\/patients\/conditions-treatments\/vertebral-compression-fractures\/\" target=\"_blank\" rel=\"noopener\">AANS. Vertebral Compression Fractures. 2023<\/a><\/li>\n<li><a href=\"https:\/\/www.aans.org\/patients\/conditions-treatments\/cauda-equina-syndrome\/\" target=\"_blank\" rel=\"noopener\">AANS. Cauda Equina Syndrome. 2023<\/a><\/li>\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng37\/chapter\/recommendations\" target=\"_blank\" rel=\"noopener\">NICE. Fractures (complex): assessment and management. 2016<\/a><\/li>\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng41\/chapter\/recommendations\" target=\"_blank\" rel=\"noopener\">NICE. Spinal injury: assessment and initial management. 2016<\/a><\/li>\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35849657\/\" target=\"_blank\" rel=\"noopener\">PubMed. Sacral Insufficiency Fractures. 2022<\/a><\/li>\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15483007\/\" target=\"_blank\" rel=\"noopener\">PubMed. Sacral insufficiency fracture. 2004<\/a><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7964142\/\" target=\"_blank\" rel=\"noopener\">PMC. Imaging and Treatment of Sacral Insufficiency Fractures. 2021<\/a><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10333055\/\" target=\"_blank\" rel=\"noopener\">PMC. CT of Sacral Fractures: Classification Systems and Management. 2023<\/a><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3279068\/\" target=\"_blank\" rel=\"noopener\">PMC. The management of sacral stress fractures: current concepts. 2012<\/a><\/li>\n<li><a href=\"https:\/\/www.secolumnavertebral.org\/\" target=\"_blank\" rel=\"noopener\">Spanish Society of Spinal Column. Blog and clinical resources. 2026<\/a><\/li>\n<li><a href=\"https:\/\/www.mayoclinic.org\/\" target=\"_blank\" rel=\"noopener\">Mayo Clinic. Clinical information on back pain and bone health. 2026<\/a><\/li>\n<\/ul>\n<p style=\"margin-top:32px;padding:16px;background:#f4f6f8;border-left:4px solid #0B2545\"><strong>Notice: this content is provided for educational and informational purposes only and does not replace assessment, diagnosis or treatment by a qualified healthcare professional. If you have any symptoms, consult a physician.<\/strong><\/p>\n<p style=\"margin-top:24px;line-height:1.7\">If symptoms persist or worsen, the most prudent step is to <a href=\"https:\/\/complexspineinstitute.com\/en\/request-evaluation\/\">request an evaluation<\/a> with a spine specialist, who can assess your specific case and advise on the most appropriate options.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sacral fragility fracture is an underdiagnosed cause of pain at the base of the back, especially in older people with osteoporosis or reduced bone strength. It is often disguised as low back pain, sacroiliac pain or even sciatica, so the problem is not only the pain but that the clinical picture does not fit a [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":9484,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_title":"Sacral fragility fracture: signs and diagnosis","rank_math_description":"How to suspect a sacral fracture when the pain doesn\u2019t fit typical low back pain, which tests confirm it, and when to refer.","rank_math_focus_keyword":"sacral fracture","footnotes":""},"categories":[19],"tags":[],"class_list":["post-9486","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurosurgery-blog"],"_links":{"self":[{"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/posts\/9486","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/comments?post=9486"}],"version-history":[{"count":1,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/posts\/9486\/revisions"}],"predecessor-version":[{"id":9491,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/posts\/9486\/revisions\/9491"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/media\/9484"}],"wp:attachment":[{"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/media?parent=9486"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/categories?post=9486"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/complexspineinstitute.com\/en\/wp-json\/wp\/v2\/tags?post=9486"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}