Skip to main content
SpringerLink
Log in

Sacroplasty

  • Chapter
  • First Online:
Image-Guided Spine Interventions

Abstract

An elderly, postmenopausal female with multiple underlying medical conditions complains of nonradiating, aching pain in the lower back and sacral area after a mild fall. Preliminary radiographs of the lumber spine show no lumbar compression fractures. The patient is managed conservatively with analgesics and bed rest. One month later, the patient continues to have nonradiating pain, and an MRI of the sacrum shows vertical nondisplaced sacral fractures. Mobility is significantly limited, and there is a component of altered mental status with higher doses of pain medications. The patient has severe osteoporosis and is not considered a candidate for open surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Grasland A, Pouchot J, Mathieu A, Paycha F, Vinceneux P. Sacral insufficiency fractures: an easily overlooked cause of back pain in elderly women. Arch Intern Med 1996;156:668-674.

    Article  CAS  PubMed  Google Scholar 

  2. Babayev M, Lachmann E, Nagler W. The controversy surrounding sacral insufficiency fractures: to ambulate or not to ambulate? Am J Phys Med Rehabil 2000;79:404-409.

    Article  CAS  PubMed  Google Scholar 

  3. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997;18:1897-1904.

    CAS  PubMed  Google Scholar 

  4. Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications, and results. Radiol Clin North Am 1998;36(3):533-546.

    Article  CAS  PubMed  Google Scholar 

  5. Cotton A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H. Percutaneous vertebroplasty: state of the art. Radiographics 1998;18:311-320.

    Google Scholar 

  6. Mathis J, Barr J, Belkoff S, Barr M, Jensen M, Deramond H. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 2001;22:373-381.

    CAS  PubMed  Google Scholar 

  7. Dehdashti AR, Martin JB, Jean B, Rüfenacht DA. PMMA cementoplasty in symptomatic metastatic lesions of the S1 vertebral body. Cardiovasc Intervent Radiol 2000;23:235-237.

    Article  CAS  PubMed  Google Scholar 

  8. Marcy PY, Palussiere J, Descamps B, Bondiau P-Y, Ciais C, Bruneton J-N. Percutaneous cementoplasty for pelvic bone metastasis. Support Care Cancer 2000;8:500-503.

    Article  CAS  PubMed  Google Scholar 

  9. Garant M. Sacroplasty: a new treatment for sacral insufficiency fracture. J Vas Interv Radiol 2002;13:1265-1267.

    Article  Google Scholar 

  10. Pommersheim W, Huang-Hellinger F, Baker M, Morris P. Sacroplasty: a treatment for sacral insufficiency fractures. AJNR Am J Neuroradiol 2003;24:1003-1007.

    PubMed  Google Scholar 

  11. Lourie H. Spontaneous osteoporotic fracture of the sacrum. an unrecognized syndrome of the elderly. JAMA 1982;248:715-717.

    Article  CAS  PubMed  Google Scholar 

  12. Pentecost RL, Murray RA, Brindley HH. Fatigue, insufficiency, and pathologic fractures. JAMA 1964;187:1001-1004.

    CAS  PubMed  Google Scholar 

  13. Hatzl-Griesenhofer M, Pichler R, Huber H, Maschek W. [The insufficiency fracture of the sacrum. An often unrecognized cause of low back pain: results of bone scanning in a major hospital]. Nuklearmedizin 2001;40(6):221-227.

    CAS  PubMed  Google Scholar 

  14. Wat SY, Seshadri N, Markose G, Balan K. Clinical and scintigraphic evaluation of insufficiency fractures in the elderly. Nucl Med Commun 2007;28(3):179-185.

    Article  PubMed  Google Scholar 

  15. Taillandier J, Langue F, Alemanni M, Taillandier-Heriche E. Mortality and functional outcomes of pelvic insufficiency fracture in older patients. Joint Bone Spine 2003;70(4):287-289.

    Article  PubMed  Google Scholar 

  16. Rawlings, CE, Wilkins RH, Martinez S, Wilkinson SH. Osteoporotic sacral fractures: a clinical study. Neurosurgery 1988;22:72-76.

    PubMed  Google Scholar 

  17. Weber M, Hasler P, Gerber H. Insufficiency fractures of the sacrum: twenty cases and review of the literature. Spine 1993;18(16):2507-2512.

    Article  CAS  PubMed  Google Scholar 

  18. Gotis-Graham I, McGuigan L, Diamond T, Portek I, Quinn R, Sturgess A, Tulloch R. Sacral insufficiency fractures in the elderly. J Bone Joint Surg 1994;76-B(6):882-886.

    Google Scholar 

  19. Renner JB. Pelvic insufficiency fractures. Arthritis Rheum 1990;33:426-430.

    Article  CAS  PubMed  Google Scholar 

  20. Garetta DJ, Yandow DR. Computed tomography of spontaneous osteoporotic sacral fractures. J Comput Assist Tomogr 1984;8:1190-1191.

    Article  Google Scholar 

  21. Grangier C, Garcia J, Howarth NR, May M, Rossier P. Role of MRI in the diagnosis of insufficiency fractures of the sacrum and acetabular roof. Skeletal Radiol 1997;26(9):517-524.

    Article  CAS  PubMed  Google Scholar 

  22. Schneider R, Yacavone J, Ghelman B. Unsuspected sacral fractures: detection by radionuclide bone scanning. AJR Am J Roentgenol 1985;144(2):337-341.

    CAS  PubMed  Google Scholar 

  23. Ries T. Detection of osteoporotic sacral fractures with radionuclides. Radiology 1983;146(3):783-785.

    CAS  PubMed  Google Scholar 

  24. Brahme SK, Cervilla V, Vint V, Cooper K, Kortman K, Resnick D. Magnetic resonance appearance of sacral insufficiency fractures. Skeletal Radiol 1990;19:489-493.

    Article  CAS  PubMed  Google Scholar 

  25. Pitton MB, Drees P, Schneider J, Brecher B, Herber S, Mohr W, Eckardt A, Heine J, Thelen M. Evaluation of percutaneous vertebroplasty in osteoporotic vertebral fractures using a combination of CT fluoroscopy and conventional lateral fluoroscopy. Rofo 2004;176(7):1005-1012.

    CAS  PubMed  Google Scholar 

  26. Frey ME, DePalma MJ, Cifu DX, Bhagia SM, Daitch JS. Efficacy and safety of percutaneous sacroplasty for painful osteoporotic sacral insufficiency fractures: a prospective, multicenter trial. Spine 2007;32(15):1635-1640.

    Article  PubMed  Google Scholar 

  27. Whitlow CT, Mussat-Whitlow BJ, Mattern CW, Baker MD, Morris PP. Sacroplasty versus vertebroplasty: comparable clinical outcomes for the treatment of fracture-related pain. AJNR Am J Neuroradiol 2007;28(7):1266-1270.

    Article  CAS  PubMed  Google Scholar 

  28. Davies AM, Evans NS, Struthers GR. Parasymphaseal and associated insufficiency fractures of the pelvis and sacrum. Br J Radiol 1988;61(722):103-108.

    Article  CAS  PubMed  Google Scholar 

  29. Peh WC, Khong PL, Ho WY, Yeung HW, Luk KD. Sacral insufficiency fractures. Spectrum of radiological features. Clin Imaging 1995;19(2):92-101.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Charles H. Cho MD, MBA (Neuroradiologist)

  2. Center for Advanced Imaging, Roanoke, VA, 24018, USA

    John M. Mathis BS, MSc (Rad. Physics), MD (Medical Director)

  3. Department of Radiology, Sharp Memorial Hospital, Del Mar, CA, 92014, USA

    Keith E. Kortman MD

Authors
  1. Charles H. Cho MD, MBA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John M. Mathis BS, MSc (Rad. Physics), MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith E. Kortman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dept. Radiology, Lewis-Gale Medical Center, Electric Road 1900, Salem, 24153, U.S.A.

    John M. Mathis

  2. Honeyridge Lane 4770, Merritt Island, 32952, U.S.A.

    Stanley Golovac

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Cho, C.H., Mathis, J.M., Kortman, K.E. (2010). Sacroplasty. In: Mathis, J., Golovac, S. (eds) Image-Guided Spine Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0352-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-0352-5_16

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0351-8

  • Online ISBN: 978-1-4419-0352-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation