Percutaneous sacroplasty using CT guidance for pain palliation in sacral insufficiency fractures.

TitlePercutaneous sacroplasty using CT guidance for pain palliation in sacral insufficiency fractures.
Publication TypeJournal Article
Year of Publication2013
AuthorsDougherty RW, McDonald JS, Cho YW, Wald JT, Thielen KR, Kallmes DF
JournalJournal of neurointerventional surgery
Date Published2013 Jan 23
Abstract

BACKGROUND AND OBJECTIVE: Sacroplasty has emerged as a treatment option for patients with painful osteoporotic sacral insufficiency fractures. We report short-term outcomes in a consecutive cohort of patients treated with sacroplasty. METHODS: We retrospectively reviewed 57 patients treated with sacroplasty for painful osteoporotic sacral fractures at our institution between 2004 and 2011. An 11-point numerical rating scale pain score was recorded at rest and at activity pre- and post-procedure. Opioids prescribed to the patient both pre- and post-procedure were recorded. RESULTS: Mean duration of pain prior to sacroplasty was 3 weeks (IQR 2-5). Procedural complications were minimal. Median post-procedure follow-up time was 2.5 weeks (IQR 1-5) among 45 patients with available data. Thirty-seven (82%) of the 45 patients experienced a numerical or descriptive decrease from initial pain at follow-up. Median activity pain scores collected from 13 patients decreased from 10 (IQR 8.5-10) pre-procedure to 6 (IQR 4-6.8) post-procedure (p<0.0001), and median rest pain scores collected from 29 patients decreased from 7 (IQR 4-8.5) to 2 (IQR 1-3.5)(p<0.0001). Twenty-two (76%) of 29 patients had at least a 30% decrease in rest pain scores. The median number of opioids prescribed per patient decreased from 1 (IQR 1-2) pre-procedure to 0 (IQR 0-1) post-procedure (p<0.0001). Thirty-four of 57 patients (60%) had decreased opioid usage, 15 (26%) patients had unchanged usage and 8 (14%) had increased usage. CONCLUSIONS: Our series demonstrates that sacroplasty is a safe and effective treatment in patients with painful osteoporotic insufficiency fractures.

DOI10.1167/iovs.12-10847
Alternate JournalJ Neurointerv Surg