A 28-year-old man sustains a sacral fracture after a fall from height. CT scan shows the fracture line passing through the sacral foramina. According to the Denis classification, this is a Zone II sacular fracture. Which nerve root is MOST commonly injured in this pattern?

• A L5 nerve root ✓
• B L4 nerve root
• C S1 nerve root
• D S2 nerve root

Explanation

Denis classification divides sacular fractures into three zones relative to the sacral foramina. Zone II fractures pass through the foramina and have the highest incidence of neurological injury, most commonly involving the L5 nerve root. Zone I fractures are lateral to the foramina and Zone III are medial, with Zone III injuries more likely to cause bowel/bladder dysfunction from cauda equina involvement.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.