title: Percutaneous sacroplasty with the use of C-arm flat-panel detector CT: technical feasibility and clinical outcome.
abstract: OBJECTIVE
  Sacroplasty for sacral insufficiency fractures (SIFs) has been performed mostly under computed tomography (CT) or fluoroscopy guidance. The purposes of this study are to describe technical tips and clinical outcomes of sacroplasty under C-arm flat panel detector CT (C-arm CT) guidance, and to compare the cement distributions shown on C-arm CT with those on multi-detector CT (MDCT).
  
  
  METHODS
  This study consisted of patients who underwent sacroplasty for SIF using C-arm CT from May 2006 to May 2009. Technical success was assessed in terms of cement filling and leakage. Clinical outcome was assessed at short-term (less than 1 month) and long-term (more than 1 month) follow-up using a four-grade patient satisfaction scale: poor, fair, good, and excellent. After sacroplasty, all patients underwent MDCT and three radiologists compared MDCT images with C-arm CT images in consensus, focusing on the cement distribution and cement leakage.
  
  
  RESULTS
  Sacroplasties were performed on both sacral alae in all 8 patients (male:female = 2:6, mean age = 76.9, range = 63-82). The technical success rate was 100%. At short-term follow up, 6 patients (87.5%) reported significant improvement. Five patients (62.5%) were available for long-term follow-up and all 5 patients reported a reduced pain and an improved ability to ambulate. Using MDCT as the standard of reference, the cement distribution was visualized equally well by C-arm CT.
  
  
  CONCLUSIONS
  Sacroplasty under C-arm CT showed excellent technical success and good clinical outcome. There was an excellent correlation between C-arm CT and MDCT in evaluating cement distribution and cement leakage.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundang-Gu, Seongnam-si, Gyeonggi-do, 463-707, Korea. koreaeun@gmail.com
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kang
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Joo Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Kun Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012447:Sacrum / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D054854:Vertebroplasty
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