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Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient?

AbstractBACKGROUND AND PURPOSE:
Sacral insufficiency fractures are an infrequent but often disabling cause of severe low back pain. We report our results of a sacroplasty technique, using CT for needle placement and fluoroscopy to monitor the polymethylmethacrylate injection in a group of patients with sacral insufficiency fractures.
METHODS:
All patients had a history of chronic back pain and had an osteoporotic sacral insufficiency fracture documented by imaging before the procedure. With the patient under conscious sedation, a bone biopsy needle was placed under CT guidance; the patient was then transferred to the fluoroscopy suite, where a polymethylmethacrylate mixture was injected into the sacrum under real-time fluoroscopy. Clinical outcome was assessed by telephone.
RESULTS:
The procedure was performed on 13 female patients with an average age of 76 years (range, 60-88 years). A bilateral procedure was performed in 11 patients and a unilateral procedure was performed in 2 patients. An average of 4.1 mL of cement was injected for each treatment. There were no instances of cement extravasation into the central canal or sacral foramina. Long-term follow-up, averaging 15 months, was available in 6 patients. Five patients (83%) reported no symptoms of pain at all. The final patient, in whom a bilateral procedure was performed, was completely asymptomatic on the left side but reported persistent unilateral pain on the right.
CONCLUSION:
Sacroplasty is a safe and effective procedure in the treatment of sacral insufficiency fractures that can provide substantial pain relief and lead to a better quality of life.
AuthorsW M Strub, M Hoffmann, R J Ernst, R V Bulas
JournalAJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 28 Issue 1 Pg. 38-41 (Jan 2007) ISSN: 0195-6108 [Print] United States
PMID17213421 (Publication Type: Journal Article)
Chemical References
  • Bone Cements
  • Polymethyl Methacrylate
Topics
  • Aged
  • Back Pain (etiology, therapy)
  • Bone Cements
  • Female
  • Fluoroscopy
  • Fractures, Spontaneous (diagnosis, therapy)
  • Humans
  • Middle Aged
  • Osteoporosis, Postmenopausal (complications, diagnosis, therapy)
  • Polymethyl Methacrylate (administration & dosage)
  • Radiology, Interventional
  • Sacrum (drug effects, injuries, pathology)
  • Spinal Fractures (diagnosis, therapy)
  • Tomography, X-Ray Computed
  • Treatment Outcome

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