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Percutaneous sacroplasty using CT guidance for pain palliation in sacral insufficiency fractures
  1. Ryne W Dougherty1,
  2. Jennifer S McDonald2,
  3. Yong Woon Cho2,
  4. John T Wald2,
  5. Kent R Thielen2,
  6. David F Kallmes2,3
  1. 1Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Department of Neurosurgery, Mayo Clinic, Rochester,  Minnesota, USA
  1. Correspondence to Ryne Dougherty, Mayo Medical School, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA; dougherty.ryne{at}mayo.edu

Abstract

Background and objective Sacroplasty has emerged as a treatment option for patients with painful osteoporotic sacral insufficiency fractures. We report short-term outcomes in a consecutive cohort of patients treated with sacroplasty.

Methods We retrospectively reviewed 57 patients treated with sacroplasty for painful osteoporotic sacral fractures at our institution between 2004 and 2011. An 11-point numerical rating scale pain score was recorded at rest and at activity pre- and post-procedure. Opioids prescribed to the patient both pre- and post-procedure were recorded.

Results Mean duration of pain prior to sacroplasty was 3 weeks (IQR 2–5). Procedural complications were minimal. Median post-procedure follow-up time was 2.5 weeks (IQR 1–5) among 45 patients with available data. Thirty-seven (82%) of the 45 patients experienced a numerical or descriptive decrease from initial pain at follow-up. Median activity pain scores collected from 13 patients decreased from 10 (IQR 8.5–10) pre-procedure to 6 (IQR 4–6.8) post-procedure (p<0.0001), and median rest pain scores collected from 29 patients decreased from 7 (IQR 4–8.5) to 2 (IQR 1–3.5)(p<0.0001). Twenty-two (76%) of 29 patients had at least a 30% decrease in rest pain scores. The median number of opioids prescribed per patient decreased from 1 (IQR 1–2) pre-procedure to 0 (IQR 0–1) post-procedure (p<0.0001). Thirty-four of 57 patients (60%) had decreased opioid usage, 15 (26%) patients had unchanged usage and 8 (14%) had increased usage.

Conclusions Our series demonstrates that sacroplasty is a safe and effective treatment in patients with painful osteoporotic insufficiency fractures.

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