title: Balloon sacroplasty as a palliative pain treatment in patients with metastasis-induced bone destruction and pathological fractures.
abstract: OBJECTIVE
  In the case of metastatic involvement of the sacrum with destruction and consecutive pathological fracture, intense disabling pain is one of the defining factors. The feasibility, safety and pain development with cement augmentation were to be investigated.
  
  
  METHODS
  CT-guided balloon sacroplasty was conducted in 10 patients with metastasis-induced bone destruction of the sacrum. After establishment of the entry point, a K-wire was first introduced as far as the central tumor lesion via the short, or transiliac axis. A cannula was then positioned over the wire. Under CT guidance, a balloon catheter was introduced through the cannula and inflated and deflated several times. The PMMA cement was then injected into the preformed cavity. The procedure was completed by a spiral CT control using the thin-slice technique. Pain intensity was determined using a visual analog scale (VAS) before the procedure, on the 2nd postoperative day and 6 months after the intervention. Finally, the patients were asked to state how satisfied they were.
  
  
  RESULTS
  Balloon sacroplasty was technically feasible in all patients. The control CT scan showed central distribution of the cement in the tumor lesion. On average 6 +/- 1.78 (4 - 10) ml of PMMA cement were introduced per treated lesion. A significant (p < 0.001) reduction in pain according to the VAS occurred in all patients from 9.3 +/- 0.67 (8 - 10) pre-operatively to 2.7 +/- 1.28 (1 - 5) on the 2nd postoperative day and 2.9 +/- 0.81 (2 - 5) 6 months after the intervention. All of the patients were re-mobilized after the procedure and underwent the further therapeutic measures as planned.
  
  
  CONCLUSIONS
  Balloon sacroplasty is a helpful therapeutic option in the overall palliative treatment of patients with tumor-induced destruction. It is a safe and practicable procedure that markedly reduces disabling pain.
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: R
authors.initials: R
authors.lastname: Andresen
authors.affiliation: Orthopedic Surgery and Traumatology, Center of Orthopedics, Berlin.
authors.forename: S
authors.initials: S
authors.lastname: Radmer
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: C W
authors.initials: CW
authors.lastname: Lüdtke
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: P
authors.initials: P
authors.lastname: Kamusella
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: C
authors.initials: C
authors.lastname: Wissgott
authors.affiliation: Department of Internal Medicine, Municipal Hospital Suedstadt Rostock, Academic Teaching Hospital of the University of Rostock.
authors.forename: H C
authors.initials: HC
authors.lastname: Schober
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010166:Palliative Care; D061214:Patient Safety; D019904:Polymethyl Methacrylate / Q000008:administration & dosage; D012447:Sacrum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019904:Polymethyl Methacrylate