Stepladder Pattern Transverse Sacral Fracture: A Previously Unreported Morphology With Neurological Recovery.

JBJS Case ConnectSep 11, 2026 (epub)
Case ReportOrthopedic SurgeryNeurosurgeryRadiology (Diagnostic)

Chitranshu Shrivastava, Tushar Narayan Rathod

✦ AI-curated · Sources linked

Case in brief

A 25-year-old man presented with cauda equina syndrome following a fall. Imaging revealed a unique transverse sacral fracture characterized by a 'stepladder' pattern, involving S1 to S4, but without significant canal compromise. The patient was treated conservatively, resulting in neurological improvement from ASIA Grade C to D, with recovery of perianal sensation and bladder function over 12 months.

What made this case unusual

The case highlights a previously unreported 'stepladder' morphology of a transverse sacral fracture, which is atypical and significant for its implications in management and recovery.

Diagnostic / clinical pearl

Clinicians should consider the potential for neurological recovery in patients with unique transverse sacral fractures, even when presenting with cauda equina syndrome.

Why it matters

Understanding this fracture morphology may influence treatment decisions and expectations for recovery in similar cases.

Source

PubMed · PMID 42726917

Published in JBJS Case Connect. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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