title: Percutaneous Imaging-Guided Screw Fixation of Osteoporotic Transverse Fractures of the Lower Sacrum with Cement Augmentation: Report of 2 Cases.
abstract: Osteoporotic fractures of the sacrum usually involve the sacral ala and can be managed with percutaneous cementoplasty if conservative therapy failed to achieve bone consolidation. On the other hand, isolated transverse fractures of the lowest sacrum are more rare, with little literature focusing on their management in the osteoporotic population. If pseudoarthrosis occurs in this location, sacroplasty is not an optimal therapeutic option because of the poor biomechanical resistance of cement to multi-directional stresses. Hence, we report two cases of chronic unhealed transverse fractures of the lowest sacrum successfully managed with percutaneous image-guided screw fixation augmented with cement injection. At last follow-up available, both patients experienced complete pain relief, without evidences of failure of the osteosynthesis on CT-scan controls.
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France. juliengarnon@gmail.com.
authors.forename: Julien
authors.initials: J
authors.lastname: Garnon
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Koch
authors.affiliation: Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Nitin
authors.initials: N
authors.lastname: Ramamurthy
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Salem
authors.initials: S
authors.lastname: Bauones
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Caudrelier
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Georgia
authors.initials: G
authors.lastname: Tsoumakidou
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Roberto Luigi
authors.initials: RL
authors.lastname: Cazzato
authors.affiliation: Department of Interventional Radiology, Hopitaux Universitaires de Strasbourg, Place de l'Hopital, 67096, Strasbourg, France.
authors.forename: Afshin
authors.initials: A
authors.lastname: Gangi
mesh_terms: D000369:Aged, 80 and over; D001863:Bone Screws; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D054854:Vertebroplasty / Q000379:methods*
keywords: Cementoplasty; Fracture; Sacrum; Screw fixation