Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions
- Keith Kortman1,
- Orlando Ortiz2,
- Todd Miller3,
- Allan Brook3,
- Sean Tutton4,
- John Mathis5,
- Bassem Georgy6
- 1San Diego Imaging, San Diego, California, USA
- 2Department of Radiology, Winthrop-University Hospital, Mineola, New York, USA
- 3Department of Radiology, Montefiore Medical Center, Bronx, New York, USA
- 4Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- 5Insight Imaging, Roanoke, Virginia, USA
- 6North County Radiology, San Diego, California, USA
- Correspondence to Dr Orlando Ortiz, Chairman, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA;
Contributors All authors have made substantial contributions to the conception and design of this project and manuscript and have provided the data stated in the Results section. All authors have participated in the drafting and redrafting of this manuscript and have approved the final version for submission.
- Received 5 March 2012
- Revised 15 May 2012
- Accepted 20 May 2012
- Published Online First 8 June 2012
Objective To assess the outcomes and safety after CT-guided percutaneous sacroplasty in patients with painful sacral insufficiency fractures or pathologic sacral lesions.
Methods A retrospective multicenter analysis of consecutive patients undergoing CT-guided sacroplasty for painful sacral insufficiency fractures or sacral lesions was undertaken. The inclusion criteria consisted of severe sacral pain not responding to conservative medical management with imaging evidence of unilateral or bilateral sacral insufficiency fractures or lesions. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and post-treatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month and for at least 1 year after their sacroplasty procedure.
Results Two hundred and forty-three patients were included in the study, 204 with painful sacral insufficiency fractures and 39 with symptomatic sacral lesions. The average pre-treatment VAS score of 9.2±1.1 was significantly improved after sacroplasty to 1.9±1.7 in patients with sacral insufficiency fractures (p<0.001). The average pre-treatment VAS score of 9.0±0.9 in patients with sacral lesions was significantly improved after sacroplasty to 2.6±2.4 (p<0.001). There were no major complications or procedure-related deaths. One patient who was treated for a sacral insufficiency fracture experienced radicular pain due to local extravasation of cement that subsequently required surgical decompression for symptomatic relief.
Conclusions CT-guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral insufficiency fractures or lesions. It is associated with prompt and durable pain relief and should be considered as an effective treatment option in this patient population.
- sacral insufficiency fracture
- CT angiography
- CT perfusion
- spinal nerve
- peripheral nerve
Competing interests None.
Ethics approval Ethics approval was provided by the Institutional Review Boards at the respective institutions.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement De-identified data sets, with full HIPAA compliance, were used to tabulate the overall data for the patients in this retrospective case series.