title: CT fluoroscopically guided percutaneous placement of transiliosacral rod for sacral insufficiency fracture: case report and technique.
abstract: Treatment of sacral insufficiency fractures (SIFs) has traditionally been conservative, but several patients have been treated with percutaneous sacroplasty. Unfortunately, in the setting of severe, bilateral SIFs, cement may not withstand shear forces present at the lumbosacral junction, and surgical hardware may not provide adequate fixation in osteoporotic, cancellous bone of the sacrum, leading to eventual pseudarthrosis. Thus, we propose a novel technique in which guidance with CT fluoroscopy allows placement of a transiliosacral bar in conjunction with sacroplasty.
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. dsciubb1@jhmi.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Sciubba
authors.forename: J-P
authors.initials: JP
authors.lastname: Wolinsky
authors.forename: K D
authors.initials: KD
authors.lastname: Than
authors.forename: Z L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: T F
authors.initials: TF
authors.lastname: Witham
authors.forename: K P
authors.initials: KP
authors.lastname: Murphy
mesh_terms: D000368:Aged; D001858:Bone Nails; D005260:Female; D005471:Fluoroscopy; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000601:surgery*; D012447:Sacrum / Q000293:injuries* / Q000601:surgery; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*