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Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures

Kamel, Ehab ; Binaghi, Stefano ; Guntern, Daniel ; Mouhsine, Elyazid ; Schnyder, Pierre ; Theumann, Nicolas

In: European Radiology, 2009, vol. 19, no. 12, p. 3002-3007

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    Titel
    • Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures
    Autor
    • Kamel, Ehab. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), CH-1011, Lausanne, Switzerland
    • Binaghi, Stefano. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), CH-1011, Lausanne, Switzerland
    • Guntern, Daniel. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), CH-1011, Lausanne, Switzerland
    • Mouhsine, Elyazid. Department of Diagnostic and Orthopaedic, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Schnyder, Pierre. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), CH-1011, Lausanne, Switzerland
    • Theumann, Nicolas. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), CH-1011, Lausanne, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Radiology, 2009, vol. 19, no. 12, p. 3002-3007. Springer-Verlag
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:320422
    Summary
    Our aim was to assess the clinical outcome of patients who were subjected to long-axis sacroplasty for the treatment of sacral insufficiency fractures. Nineteen patients with unilateral (n = 3) or bilateral (n = 16) sacral fractures were involved. Under local anaesthesia, each patient was subjected to CT-guided sacroplasty using the long-axis approach through a single entry point. An average of 6ml of polymethylmethacrylate (PMMA) was delivered along the path of each sacral fracture. For each individual patient, the Visual Analogue pain Scale (VAS) before sacroplasty and at 1, 4, 24 and 48weeks after the procedure was obtained. Furthermore, the use of analgesics (narcotic/non-narcotic) along with the evolution of post-interventional patient mobility before and after sacroplasty was also recorded. The mean pre-procedure VAS was 8 ± 1.9 (range, 2 to 10). This rapidly and significantly (P < 0.001) declined in the first week after the procedure (mean 4 ± 1.4; range, 1 to 7) followed by a gradual and significant (P < 0.001) decrease along the rest of the follow-up period at 4weeks (mean 3 ± 1.1; range, 1 to 5), 24weeks (mean 2.2 ± 1.1; range, 1 to 5) and 48weeks (mean 1.6 ± 1.1; range, 1 to 5). Eleven (58%) patients were under narcotic analgesia before sacroplasty, whereas 8 (42%) patients were using non-narcotics. Corresponding values after the procedure were 2/19 (10%; narcotic, one of them was on reserve) and 10/19 (53%; non-narcotic). The remaining 7 (37%) patients did not address post-procedure analgesic use. The evolution of post-interventional mobility was favourable in the study group as they revealed a significant improvement in their mobility point scale (P < 0.001). Long-axis percutaneous sacroplasty is a suitable, minimally invasive treatment option for patients who present with sacral insufficiency fractures. More studies with larger patient numbers are needed to explore any unrecognised limitations of this therapeutic approach