Devoted to diagnostic and interventional spine imaging and therapeutics

Library

Multicenter study to assess the efficacy and safety of sacroplasty in patients with pathologic sacral lesions. 2012

Interventional Spine

A. Orlando, Ortiz, MD, MBA, FACR
Keith, Kortman, MD, Non ASSR Member
Todd, Miller, MD, Non ASSR Member
Allan, Brook, MD, Non ASSR Member
Bassem, Georgy, MD, Non ASSR Member
John, Mathis, MD, Non ASSR Member

Paper/Non-Mentor

Purpose

To assess the outcomes and safety after CT guided percutaneous sacroplasty in patients with symptomatic sacral lesions.

Methods & Materials

A retrospective multicenter analysis of consecutive patients undergoing image guided sacroplasty for painful sacral lesions. All procedures were performed with CT, CT and fluoroscopy or CT fluoroscopy. The inclusion criteria consisted of severe sacral pain imaging (MRI, CT and/or skeletal scintigraphy) a sacral lesion. A biopsy was performed in all cases. The number of bone needles (13 or 11 g) and the volume of injected acrylic bone cement were also documented. Outcome measures included hospitalization status (inpatient or outpatient), pre-treatment and post treatment visual analog scale (VAS) scores, analgesic use and complications. Patients were followed at approximately 1 month.

Results

28 patients were included in this study, 20 of whom were female and 8 were male. The average patient age was 68.7 years. Malignant lesions were diagnosed in 26 of the patients; 9 patients had multiple myeloma, 15 had metastatic disease, 2 had leukemia. Two patients had benign lesions, one patient with a hemangioma and the other with a cyst. Bilateral sacral lesions were identified in 15 patients and unilateral lesions were seen in 13 patients. 14 patients were evaluated and treated as inpatients and 14 patients were managed as outpatients. The average pre-treatment VAS score of 8.9 +/- 1.0 was significantly improved after sacroplasty to 2.2 +/- 2.0 (p<0.0001; 2 tailed paired t-test). 7 of the 28 patients (25%) reported complete pain relief. Marked reductions in analgesic use were observed in this latter group of patients. There were no procedure-related deaths, infections, pulmonary emboli, significant cement extravasations or hemorrhages.

Conclusion

CT guided percutaneous sacroplasty is a safe and effective procedure in the treatment of painful sacral neoplastic and benign sacral lesions.

References/Financial Disclosures

1. Cho CH, Mathis JM, Ortiz AO. Sacral fractures and sacroplasty. Neuroimaging Clinics of North America. 2010;20:179-186 2.Marcy PY, Palussiere J, Descamps B, et al: Percutaneous cementoplasty for pelvic bone metastasis. Support Care Cancer 2000; 8:500-503 Financial Disclosures AO Ortiz: Speakers Bureau - Medtronic Spine, Orthovita Spine

[gallery]