L4 Fixation is not necessary in L5-Iliac Spinopelvic Fixation after trauma, but Coadjutant Transilio-Transsacral Fixation is.

Spinopelvic dissociation (SPD) is a severe injury characterized by a discontinuity between the spine and the bony pelvis consisting of a bilateral longitudinal sacral fracture, most of the times through sacral neuroforamen, and a horizontal fracture, usually through the S1 or S2 body [1,2,3]. Since SPD results after high energy injuries, like a fall from height, traffic accidents or blast injuries [4], most of the times it is found in a polytraumatized patient, associated with other life-threatening injuries [5].
Source: Injury - Category: Orthopaedics Authors: Source Type: research