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Sacroplasty: Pain Relief for Sacral Lesions and Sacral Insufficiency Fractures 2004

Dickson, Asante, M.D., Dipietro, Joseph, Murphy, Kieran, M.D., Ortiz, Orlando, MD, MBA, Mathis, John, MD., MSc

Purpose:
Sacral lesions are a potential cause of debilitating low back pain. We discuss the role of sacral vertebroplasty or sacroplasty, in the treatment of neoplastic and osteoporotic sources of sacral pain.

Methods and Materials:
Informed consent was obtained prior to each procedure. Sacroplasty was performed using polymethylmethacrylate cement in seven patients using either biplane fluoroscopy (2 patients) or combined fluoroscopy and computed tomography in five patients. Three patients had metastatic disease to the sacrum, one patient had multiple myeloma, one patient had a sacral hemangioma, and two patients had osteoporotic sacral
insufficiency fractures. Clinical outcome was measured via clinical follow up, by the presence or absence of pain relief following the procedure.

Results:
The sacroplasty technique was successful in all 7 patients. Moreover, we demonstrated the precise delivery of polymethylmethacrylate cement into identified sacral tumors and fractures using a combination of fluoroscopic and CT guidance. All 7 procedures were completed without complication and resulted in significant pain relief.

Conclusion:
The injection of polymethylmethacrylate cement into neoplastic and osteoporotic lesions has been shown to provide symptomatic relief of pain and, in the majority of patients, improved functional activity.