Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures with a radiofrequency-induced, high-viscosity bone cement.
Our goal was to assess the technical results in patients who underwent long-axis sacroplasty for the treatment of sacral insufficiency fractures (SIF) by radiofrequency-induced high-viscosity bone cement augmentation. Twelve patients with bilateral sacral fractures were treated by augmentation with radiofrequency-activated, high-viscosity polymethylmethacrylate (PMMA) bone cement under local anesthesia. CT-guided sacroplasty was performed by using a long-axis approach through a single entry point. Thirty-six vertebrae were treated in 12 sessions under a combination of CT and fluoroscopic guidance using a bilateral access and a cavity-creating osteotome prior to remote-controlled, hydraulically driven cement injection. The visual analogue scale (VAS) score before sacroplasty and at 1 and 3 months after the treatment was obtained. PMMA leaks were evaluated retrospectively using the post-interventional CT. The mean amount of high-viscosity PMMA injected per patient was 7.8 ml. No major adverse events were observed. In the first 4 days after the procedure, the mean VAS score decreased from 8.1 ± 1.9 to mean 3.1 ± 1.2 and was followed by a gradual but continuous decrease throughout the rest of the follow-up period at 24 weeks (mean 2.2 ± 1.1) and 48 weeks (mean 2.1 ± 1.4). CT fluoroscopy-guided sacral augmentation was safe and effective in all 12 patients with osteoporotic SIF.
Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt, Germany, k.eichler@em.uni-frankfurt.de.
Katrin
K
Eichler
Stephan
S
Zangos
Martin G
MG
Mack
Ingo
I
Marzi
Thomas J
TJ
Vogl
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000737:chemistry / Q000528:radiation effects / Q000627:therapeutic use; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000737:chemistry / Q000528:radiation effects / Q000627:therapeutic use*; D011846:Radio Waves; D011859:Radiography; D012447:Sacrum / Q000293:injuries* / Q000528:radiation effects; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D014783:Viscosity
D001843:Bone Cements; D019904:Polymethyl Methacrylate