From keystone to Kundalini: The sacrum carries profound cultural and biological significance

Stuart A. Green, MD, FAAOS

Theology aside, the sacrum has an interesting evolutionary history.

Disruptions of the SI joint and fractures of the sacrum associated with pelvic ring injuries

John A. Scolaro, MD, MA, FAAOSS

The sacrum has historically been referred to as the keystone of the pelvis given its central position as well as its articulation with the axial spinal column. The sacrum has adjacent sacroiliac (SI) joints, though cartilaginous, primarily function to provide shock absorption and stability to the pelvis during weight bearing. The anterior and posterior SI ligaments are incredibly robust and allow little motion during most activities.

Sacral bone tumors: balancing oncologic control with nerve preservation

Russell Stitzlein, MD

Sacral tumors demand precise imaging, biopsy, and multidisciplinary planning to balance oncologic control with nerve preservation and patient function.

Rare transverse sacral fractures pose high risk for neurological dysfunction

Philip K. Lim, MDS

Although sacral fractures are uncommon, their transverse variants pose unique challenges.