Fluoroscopy-guided sacroplasty: special focus on preoperative planning from three-dimensional computed tomography

Abstract

Sacral insufficiency fractures are not uncommon and should be considered in the elderly population with low back pain. Sacroplasty using the optimized "long-axis technique" gave almost immediate pain relief for all five patients in our study material. No complications were observed.

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

“…The symptoms settled with an S1 nerve root injection 1 week later. A further case was refractory to pain despite a repeat procedure being performed [14].…”

“…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.…”

“…Strub et al [27] limited the cement volume to 8 ml per patient, whereas Gjertsen et al [14] used up to 10 ml per sacral side. 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].…”

“…In our review, the posterior approach was the commonest described, with lateral approaches only being used when iliosacral screws are being placed [26,28] simultaneously. However, the majority of 'simple' sacroplasty procedures are being reported from departments of radiology [4,6,7,12,14,16,19,23,26,27,30], with only four papers originating from other departments (e.g. neurosurgery and orthopaedics) [9,11,25,28].…”

“…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.…”