Safety and efficacy of percutaneous sacroplasty for treatment of sacral insufficiency fractures: a systematic review

Mahmood, Bilal; Pasternack, Jordan B.; Razi, Afshin E.; Saleh, Ahmed

doi:10.21037/jss.2019.06.05

Cited by 32 publications

(31 citation statements)

References 28 publications

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“…The pooled major complication rate from the intervention was small at 0.3%. Similarly in a systematic review, Mahmood et al [14], reported the mean reduction in pain score from pre-procedure to latest follow-up post-procedure VAS to be 5.8 + 1.3, while the risk of cement extravasation (the most commonly reported complication), clinically insigni cant in the majority of studies included. Two studies reported S1 radicular pain after the procedure while only one study reported a patient with persistent pain requiring re-operation.…”

Section: Discussionmentioning

confidence: 95%

“…Spinal surgeons interviewed advocated early sacroplasty for patients con rmed with a sacral fragility fracture and unable to mobilise. Key-hole, minimally invasive surgery (sacroplasty) has been shown to be safe, effective for pain relief and improves mobility when compared to conservative (non-surgical) treatment [13][14][15]. A meta-analysis by Chandra et al [13], which included 19 trials, demonstrated statistically signi cant differences in the visual analogue scale (VAS) pain level at pre-procedure, 24-48 hours, 6 months, and 12 months follow up, with cumulative pain scores of 8.32 ± 0.01, 3.55 ± 0.01, 1.48 ± 0.01, and 0.923 ± 0.01, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…However, even when seated, the load bearing on the sacrum is signi cant, and in the presence of a sacral fragility fracture, is extremely painful. Key-hole, minimally invasive surgery (sacroplasty) is routinely available for the treatment of sacral fragility fractures and has been shown to be safe, effective for pain relief and improves mobility when compared to conservative (non-surgical) treatment [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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ASSERT (Acute Sacral inSufficiEncy fractuRe augmenTation): Perceptions in the Assessment and Treatment of Pubic Rami and Sacral Fragility Fractures Amongst Healthcare Professionals in Geriatric Medicine and Surgery.

Sahota

Leighton

Cameron

et al. 2021

Preprint

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Background: Pubic rami fragility fractures are common in older people and result in significant morbidity and increased mortality. Co-existing fractures of the sacrum are common, but routinely missed. The aim of the study was to explore the perceptions in the assessment and treatment of pubic rami and sacral fragility fractures amongst healthcare professionals. Methods: We interviewed 14 participants about their experience in the assessment and treatment of patients presenting with pubic rami fragility fractures. Data was analysed using an inductive thematic approach.Results: The majority of patients presenting with a pubic rami fragility fracture were managed by geriatricians. However, many of the geriatricians were not aware that these fractures have a high association with co-existing sacral fragility fractures. Furthermore, they were not aware of the limitations of standard x-ray imaging, nor of the potential benefits of surgical intervention for sacral fragility fractures. Spinal surgeons recommended that early, more specialist imaging in patients with public rami fragility fractures failing to mobilise, would change clinical management, if found to have a coexisting sacral fragility fracture, amenable to surgical intervention. Conclusions: The awareness, assessment and management of sacral fragility fractures in patients presenting with pubic rami fragility fractures is poor amongst healthcare professional in geriatric medicine. Spinal surgeons in this study advocate early further imaging and surgical intervention in patients confirmed to have a concomitant sacral fragility fracture who are failing to mobilise.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ASSERT (Acute Sacral inSufficiEncy fractuRe augmenTation): Perceptions in the Assessment and Treatment of Pubic Rami and Sacral Fragility Fractures Amongst Healthcare Professionals in Geriatric Medicine and Surgery.

Sahota

Leighton

Cameron

et al. 2021

Preprint

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“…It was reported that pain control was achieved in 59% of the cases only by using injections; the success rate was stated to be 85% when injection and manipulation were combined. However, there is a relapse rate of about 28% ( 10 ). Surgical procedures must be considered in cases when there is no response received from all other treatment methods.…”

Section: Discussionmentioning

confidence: 99%

“…This method is similar to vertebroplasty and sacroplasty and ensures pain control as well as mechanical stabilization of fracture by applying PMMA cement. This technique can be rapidly and safely applied to a patient with osteoporotic coccygeal fracture who has refractory pain ( 5 , 10 ). The neurological complication risk of this procedure is very low since there is no spinal canal at the coccygeal level.…”

Section: Discussionmentioning

confidence: 99%

Polymethylmetacrylate Cement Augmentation of the Coccyx (Coccygeoplasty) for Fracture: A Case Report

Akar¹,

Koban²,

Öğrenci³

et al. 2020

Balkan Med J

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Background: Coccydynia is a painful condition of the sacrococcygeal region, with symptoms associated with sitting and rising from a seated position. It is frequently related to trauma and idiopathic causes, and the pain is mostly chronic. Percutaneous vertebroplasty and sacroplasty are the methods that are widely used for treating compression fractures and sacral insufficiency fractures, respectively. However, the success of polymethylmethacrylate injection in the treatment of osteoporotic coccyx fractures and coccydynia is still unknown. Case Report: A 68-year-old man was admitted to our clinic with complaints of pain in the sacrococcygeal and perianal regions. In the imaging studies, a fracture line in the fifth sacral and first coccygeal segments was observed as evidenced by a bony edema. Since the patient’s pain did not improve with conservative methods, we treated him with coccygeoplasty. No complication was encountered. The day after the operation, he was discharged from the hospital with complete pain relief. The patient confirmed having no pain on the third postoperative month and so did not need any analgesics. Conclusion: Coccyceoplasty may be a good treatment option for retractable pain in patients with acute or subacute osteoporotic coccygeal fractures and coccydinia with edema.

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Complications of Sacroplasty

Cordner¹

2022

Complications of Pain‐Relieving Procedures

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Safety and efficacy of percutaneous sacroplasty for treatment of sacral insufficiency fractures: a systematic review

Cited by 32 publications

References 28 publications

ASSERT (Acute Sacral inSufficiEncy fractuRe augmenTation): Perceptions in the Assessment and Treatment of Pubic Rami and Sacral Fragility Fractures Amongst Healthcare Professionals in Geriatric Medicine and Surgery.

ASSERT (Acute Sacral inSufficiEncy fractuRe augmenTation): Perceptions in the Assessment and Treatment of Pubic Rami and Sacral Fragility Fractures Amongst Healthcare Professionals in Geriatric Medicine and Surgery.

Polymethylmetacrylate Cement Augmentation of the Coccyx (Coccygeoplasty) for Fracture: A Case Report

Complications of Sacroplasty

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