Computerized Tomography Guided Sacroplasty: A Practical Treatment for Sacral Insufficiency Fracture

Abstract

Under CT guidance, sacroplasty is a safe, practical, and effective solution to this underdiagnosed problem, with potential for comorbidities resulting in prolonged, costly hospital admissions for the elderly.

Clinical outcomes of sacroplasty in sacral insufficiency fractures: a review of the literature

“…The average VAS improved from a pre-operative score of 8.9 to 2.6 post-operatively [4,6,9,11,16,25]. This is statistically significant (P \ 0.001, paired Student's t test).…”

“…There are only five papers which include follow-up of 1 year or more [6,11,14,16,27,30], despite the fact that most journals require at least 12 months of follow-up for reports of surgical outcomes. It is, therefore, unusual to see so many case reports on a subject, without these requirements met.…”

“…Three patients sustained H-type fractures [4,6,23] with each undergoing sacroplasty without concomitant iliosacral screw fixation. Binaghi et al [4] describe an H-type fracture in a patient with a history of lymphoma.…”

“…Layton et al [19] described injecting 2 ml of cement per vertebral body instrumented, similar to that of Tjardes et al [28] and Frey et al [11]. Unfortunately, Brook et al [6], Smith and Dix [26] and Sciubba et al [25] did not comment on the amount of cement they injected despite describing their technique.…”

“…However, the risks and benefits of this procedure are not yet fully understood. Sacroplasty remains an evolving technique and numerous methods have been described in the form of technical reports with accompanying case reports or small case series [4,6,7,9,11,12,14,16,19,23,[25][26][27][28]30]. So far, no consensus has been agreed with regard to best practise.…”