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Sacroplasty: A Treatment for Sacral Insufficiency Fractures

William Pommersheim, Frank Huang-Hellinger, Michael Baker and Pearse Morris
American Journal of Neuroradiology May 2003, 24 (5) 1003-1007;
William Pommersheim
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Frank Huang-Hellinger
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Michael Baker
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Pearse Morris
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    Fig 1.

    Case 1, a 76-year-old woman with low back pain.

    A, Pelvic radiograph shows degenerative lumbar changes. Note, however, that the sacrum is unremarkable.

    B, Bone scan shows the H sign diagnostic of a sacral insufficiency fracture. Prominent renal activity on the scan is a normal finding.

    C, Cortical disruption (arrows) on a non-contrast-enhanced pelvic CT scan confirms fracture.

    D and E, Anteroposterior (D) and lateral (E) fluoroscopic images show cement in the L4 vertebral body and cement bilaterally in the sacral ala. The lateral view illustrates the difficulty with visualization within the sacrum during this technique.

    F, Postoperative pelvic CT scan shows cement within the bilateral superior sacral ala in the vicinity of the fracture lines

    G, Follow-up pelvic radiograph shows the cement within the superior sacrum

  • Fig 2.
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    Fig 2.

    Case 2, a 71-year-old woman with sacral insufficiency fracture.

    A and B, Anteroposterior (A) and lateral (B) venograms do not clearly confirm needle tip placement within the sacrum. Again, notice the difficulty in confirming the needle tip location as being entirely intraosseous.

    C and D, Anteroposterior (C) and lateral (D) fluoroscopic images show cement within the sacrum.

    E, Postoperative pelvic CT scan shows cement within the left sacrum, but the right sacral injection has resulted in a portion of the cement being positioned within the posterior soft tissue

  • Fig 3.
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    Fig 3.

    Case 3, a 74-year-old woman with sacral insufficiency fracture.

    A and B, Preoperative sacral MR images show low-T1 (A[TR/TE, 450/14]) and high-T2 (B[4000/99]) signal intensity, consistent with the edema from a sacral insufficiency fracture.

    C, Pelvic CT scan illustrates the two intended needle paths, simplifying needle placement during sacroplasty.

    D, Postoperative CT confirms cement location.

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American Journal of Neuroradiology: 24 (5)
American Journal of Neuroradiology
Vol. 24, Issue 5
1 May 2003
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Sacroplasty: A Treatment for Sacral Insufficiency Fractures
William Pommersheim, Frank Huang-Hellinger, Michael Baker, Pearse Morris
American Journal of Neuroradiology May 2003, 24 (5) 1003-1007;

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Sacroplasty: A Treatment for Sacral Insufficiency Fractures
William Pommersheim, Frank Huang-Hellinger, Michael Baker, Pearse Morris
American Journal of Neuroradiology May 2003, 24 (5) 1003-1007;
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Cited By...

  • Single-Needle Lateral Sacroplasty Technique
  • Fragility Fractures of the Pelvis
  • Percutaneous sacroplasty using CT guidance for pain palliation in sacral insufficiency fractures
  • Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions
  • Percutaneous sacroplasty
  • Imaging and Treatment of Sacral Insufficiency Fractures
  • Percutaneous Cement Augmentations of Malignant Lesions of the Sacrum and Pelvis
  • An Easily Identifiable Anatomic Landmark For Fluoroscopically Guided Sacroplasty: Anatomic Description and Validation with Treatment in 13 Patients
  • Biomechanical Analysis of Sacroplasty: Does Volume or Location of Cement Matter?
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