Computerized Tomography Guided Sacroplasty: A Practical Treatment for Sacral Insufficiency Fracture

In Brief Study Design. Small case series projecting widespread therapeutic implications. Objective. To promote sacroplasty as a feasible treatment for sacral insufficiency fractures. Summary of Background Data. Osteoporosis, a major cause of vertebral and sacral insufficiency fractures, is an increasingly serious problem in the elderly population. Painful sacral fractures often cause patients to be immobile, and at increased risk for comorbidities and osteoporosis progression. Currently, there is no therapy available for the treatment of these fractures. Vertebroplasty has evolved as a standard of care for treating fractures as a result of malignant and nonmalignant spinal pathology. Sacroplasty represents a reasonable adaptation of this interventional technique. Methods. Computerized tomography (CT) guidance was used to monitor percutaneous polymethylmethacrylate injection into sacral insufficiency fractures. Results. We report 2 cases of elderly patients with posttraumatic sacral insufficiency fractures, whose symptoms were completely relieved following CT-guided internal fixation by percutaneous polymethylmethacrylate injection. Conclusion. Under CT guidance, sacroplasty is a safe, practical, and effective solution to this underdiagnosed problem, with potential for comorbidities resulting in prolonged, costly hospital admissions for the elderly. Sacral insufficiency fracture is a common but often unsuspected cause of lower back pain in elderly patients with osteoporosis. These fractures can be treated with sacroplasty using computerized tomography guidance for the percutaneous injection of polymethylmethacrylate into the fracture sites. Sacroplasty is a practical, effective, and cost-effective treatment for such fractures.