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Research ArticleSPINE

Sacroplasty by CT and Fluoroscopic Guidance: Is the Procedure Right for Your Patient?

W.M. Strub, M. Hoffmann, R.J. Ernst and R.V. Bulas
American Journal of Neuroradiology January 2007, 28 (1) 38-41;
W.M. Strub
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M. Hoffmann
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R.J. Ernst
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R.V. Bulas
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  • Fig 1.
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    Fig 1.

    CT images from needle placement in 2 different patients with sacral insufficiency fractures illustrating the possible orientation for the bone biopsy needle(s) in the sacrum.

    A, Axial image showing vertical orientation of the bone biopsy needles in a patient with bilateral fractures.

    B. Axial image showing an oblique orientation, paralleling the sacroiliac joint of the bone biopsy needle, in a patient with a unilateral fracture.

  • Fig 2.
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    Fig 2.

    Fluoroscopic spot films taken during the PMMA injection in a 65-year-old woman with bilateral sacral insufficiency fractures.

    A, Frontal projection allows for monitoring of extravasation into the sacral foramina.

    B, Lateral projection allows for monitoring for any cement extravasation into the soft tissues.

Tables

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  • Previous studies of sacroplasty in patients with osteoporotic insufficiency fractures

    Needle PlacementCement InjectionComplication(s)Clinical Follow-Up
    Garant et al4Fluoroscopy under general anesthesia. Chiba needles placed in sacral foramina.FluoroscopyNone reportedAmbulatory and pain-free 9 months postprocedure
    Brook et al1CT Guidance under general anesthesia in 2 patients.Intermittent CTPremature cement hardeningPain-free and ambulating at 8 and 16 months
    Pommersheim et al3Fluoroscopy in 2 patients. CT guidance in 1. Patients under conscious sedation.Fluoroscopy in allCement extravasation in posterior soft tissuesPain-free at 14 and 16 weeks. One patient lost to follow-up
    Deen and Nottmeier2Kyphoplasty with fluoroscopy in 2 patients. Brain LAB in one patient.Fluoroscopy in 2, Brain LAB in 1None reportedDecreased pain and increased function 3, 6, and 9 months after procedure
    Butler et al7CT fluoroscopy under conscious sedation in 6 patients.Fluoroscopy in 5, CT in 1Inadequate cement distribution, venous intravasation, and extension into SI joint2–8 weeks. Significantly reduced or eliminated pain in 4 patients
    • Note:—SI indicates sacroiliac.

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American Journal of Neuroradiology: 28 (1)
American Journal of Neuroradiology
Vol. 28, Issue 1
January 2007
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Sacroplasty by CT and Fluoroscopic Guidance: Is the Procedure Right for Your Patient?
W.M. Strub, M. Hoffmann, R.J. Ernst, R.V. Bulas
American Journal of Neuroradiology Jan 2007, 28 (1) 38-41;

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Sacroplasty by CT and Fluoroscopic Guidance: Is the Procedure Right for Your Patient?
W.M. Strub, M. Hoffmann, R.J. Ernst, R.V. Bulas
American Journal of Neuroradiology Jan 2007, 28 (1) 38-41;
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Cited By...

  • 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
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