Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions

Keith Kortman, Orlando Ortiz, Todd S. Miller, Allan L. Brook, Sean Tutton, John Mathis, Bassem Georgy

Research output: Contribution to journalArticle

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Abstract

Objective: To assess the outcomes and safety after CTguided percutaneous sacroplasty in patients with painful sacral insufficiency fractures or pathologic sacral lesions. Methods: A retrospective multicenter analysis of consecutive patients undergoing CT-guided sacroplasty for painful sacral insufficiency fractures or sacral lesions was undertaken. The inclusion criteria consisted of severe sacral pain not responding to conservative medical management with imaging evidence of unilateral or bilateral sacral insufficiency fractures or lesions. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and posttreatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month and for at least 1 year after their sacroplasty procedure. Results: Two hundred and forty-three patients were included in the study, 204 with painful sacral insufficiency fractures and 39 with symptomatic sacral lesions. The average pre-treatment VAS score of 9.2±1.1 was significantly improved after sacroplasty to 1.9±1.7 in patients with sacral insufficiency fractures (p < 0.001). The average pre-treatment VAS score of 9.0±0.9 in patients with sacral lesions was significantly improved after sacroplasty to 2.6±2.4 (p < 0.001). There were no major complications or procedure-related deaths. One patient who was treated for a sacral insufficiency fracture experienced radicular pain due to local extravasation of cement that subsequently required surgical decompression for symptomatic relief. Conclusions: CT-guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral insufficiency fractures or lesions. It is associated with prompt and durable pain relief and should be considered as an effective treatment option in this patient population.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalJournal of NeuroInterventional Surgery
Volume5
Issue number5
DOIs
StatePublished - Sep 2013

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Stress Fractures
Multicenter Studies
Safety
Visual Analog Scale
Pain
Therapeutics
Surgical Decompression
Analgesics
Inpatients
Hospitalization
Outpatients
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions. / Kortman, Keith; Ortiz, Orlando; Miller, Todd S.; Brook, Allan L.; Tutton, Sean; Mathis, John; Georgy, Bassem.

In: Journal of NeuroInterventional Surgery, Vol. 5, No. 5, 09.2013, p. 461-466.

Research output: Contribution to journalArticle

Kortman, Keith ; Ortiz, Orlando ; Miller, Todd S. ; Brook, Allan L. ; Tutton, Sean ; Mathis, John ; Georgy, Bassem. / Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions. In: Journal of NeuroInterventional Surgery. 2013 ; Vol. 5, No. 5. pp. 461-466.
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abstract = "Objective: To assess the outcomes and safety after CTguided percutaneous sacroplasty in patients with painful sacral insufficiency fractures or pathologic sacral lesions. Methods: A retrospective multicenter analysis of consecutive patients undergoing CT-guided sacroplasty for painful sacral insufficiency fractures or sacral lesions was undertaken. The inclusion criteria consisted of severe sacral pain not responding to conservative medical management with imaging evidence of unilateral or bilateral sacral insufficiency fractures or lesions. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and posttreatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month and for at least 1 year after their sacroplasty procedure. Results: Two hundred and forty-three patients were included in the study, 204 with painful sacral insufficiency fractures and 39 with symptomatic sacral lesions. The average pre-treatment VAS score of 9.2±1.1 was significantly improved after sacroplasty to 1.9±1.7 in patients with sacral insufficiency fractures (p < 0.001). The average pre-treatment VAS score of 9.0±0.9 in patients with sacral lesions was significantly improved after sacroplasty to 2.6±2.4 (p < 0.001). There were no major complications or procedure-related deaths. One patient who was treated for a sacral insufficiency fracture experienced radicular pain due to local extravasation of cement that subsequently required surgical decompression for symptomatic relief. Conclusions: CT-guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral insufficiency fractures or lesions. It is associated with prompt and durable pain relief and should be considered as an effective treatment option in this patient population.",
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N2 - Objective: To assess the outcomes and safety after CTguided percutaneous sacroplasty in patients with painful sacral insufficiency fractures or pathologic sacral lesions. Methods: A retrospective multicenter analysis of consecutive patients undergoing CT-guided sacroplasty for painful sacral insufficiency fractures or sacral lesions was undertaken. The inclusion criteria consisted of severe sacral pain not responding to conservative medical management with imaging evidence of unilateral or bilateral sacral insufficiency fractures or lesions. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and posttreatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month and for at least 1 year after their sacroplasty procedure. Results: Two hundred and forty-three patients were included in the study, 204 with painful sacral insufficiency fractures and 39 with symptomatic sacral lesions. The average pre-treatment VAS score of 9.2±1.1 was significantly improved after sacroplasty to 1.9±1.7 in patients with sacral insufficiency fractures (p < 0.001). The average pre-treatment VAS score of 9.0±0.9 in patients with sacral lesions was significantly improved after sacroplasty to 2.6±2.4 (p < 0.001). There were no major complications or procedure-related deaths. One patient who was treated for a sacral insufficiency fracture experienced radicular pain due to local extravasation of cement that subsequently required surgical decompression for symptomatic relief. Conclusions: CT-guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral insufficiency fractures or lesions. It is associated with prompt and durable pain relief and should be considered as an effective treatment option in this patient population.

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