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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:1451-1454, September 2007
DOI 10.3174/ajnr.A0665
© 2007 American Society of Neuroradiology

Technical Note
SPINE

CT Fluoroscopically Guided Percutaneous Placement of Transiliosacral Rod for Sacral Insufficiency Fracture: Case Report and Technique

D.M. Sciubba^a, J.-P. Wolinsky^a, K.D. Than^a, Z.L. Gokaslan^a, T.F. Witham^a and K.P. Murphy^b

^a Departments of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Md
^b Radiology, Johns Hopkins University School of Medicine, Baltimore, Md

Please address correspondence to Daniel M. Sciubba, MD, 600 North Wolfe St, Meyer Building 8-161, Baltimore, MD 21237; e-mail: dsciubb1{at}jhmi.edu

SUMMARY: Treatment of sacral insufficiency fractures (SIFs) has traditionally been conservative, but several patients have been treated with percutaneous sacroplasty. Unfortunately, in the setting of severe, bilateral SIFs, cement may not withstand shear forces present at the lumbosacral junction, and surgical hardware may not provide adequate fixation in osteoporotic, cancellous bone of the sacrum, leading to eventual pseudarthrosis. Thus, we propose a novel technique in which guidance with CT fluoroscopy allows placement of a transiliosacral bar in conjunction with sacroplasty.