Lumbo-sacral nerve root injury

Before undertaking definitive treatment of pelvic ring injuries, it is essential to know the functional status of the patient's lumbosacral nerve roots. A careful and detailed examination is necessary, to assess perineal sensation, voluntary anal sphincter contraction, and bulbo-cavernosus reflex. Cystometrography may be helpful to assess bladder neuromotor function.
Neurologic abnormalities should be correlated with anatomic site of injury:

• If a lumbo-sacral nerve deficit is present in extra sacral injuries, further investigation and possible treatment must be considered.
• If a sacral nerve deficit is present with a sacral fracture, the nerves should be decompressed with fracture reduction and/or sacral laminectomy