medigraphic.com

2012, Number 6

<< Back Next >>

Cir Cir 2012; 80 (6)

Sacral insufficiency, unexpected clinical entity as a cause of low back pain. Report of two cases

Bustamante-Vidales JC, Kleriga-Grossgere E, Zambito-Brondo GF, Higuera-Calleja J

Language: Spanish
References: 30
Page: 556-561
PDF size: 242.53 Kb.


ABSTRACT

Background: sacral insufficiency fractures are a cause of debilitating pain in the elderly. First described these fractures as a clinical entity in 1982. The bone in these patients is structurally weakened and often associated with diseases such as osteoporosis, cancer and immunological processes. This translates into back and pelvic pain unrelated to trauma. These fractures are usually caused by fatigue in most cases. Bone scans and MRI are the imaging studies with the most sensitivity for detecting sacral insufficiency.
Clinical cases: two patients with sacral insufficiency fractures who were studied by MRI and bone scan, in whom the diagnosis of sacral insufficiency was made, were treated by sacroplasty.
Conclusions: the sacral insufficiency is a disease under diagnosed, caused by wide range of diseases, mainly osteoporosis. The studies of choice for diagnosis are MRI and bone scans. The techniques such as percutaneous sacroplasty produce significant improvements in pain scores and seem a suitable alternative to management of this disease.


REFERENCES

  1. Lyders EM, Whitlow CT, Baker MD, Morris PP. Imaging and Treatment of Sacral Insufficiency Fractures. Am J Neuroradiol 2010;31:201-210.

  2. Cho Ch H, Mathis JM, Ortíz O. Sacral Fractures and Sacroplasty. Neuroimag Clin N Am 2010;20(2):179-186.

  3. Kyung-Mi Ch, Joon-Ho S, Sung-Ki A, Hyun-Chul Ch. Therapeutic Considerations of Percutaneus Sacroplasty for de Sacral Insufficiency Fracture. J Korean Neurosurg Soc 2010;47(1):58-63.

  4. Yong-Jeon L, Ho-Jin B, Jong TK, Dong-Sup C. Sacral Insufficiency Fracture, Usually Overlooked Cause of Lumbosacral Pain. J Korean Neurosurg Soc 2008;44(3):166-169.

  5. Linstrom NJ, Heiserman JE, Kortman KE, Crawford NR, Baek S, Anderson RL, et al. Anatomical and Biomechanical Analyses of the Unique and Consistent Locations of Sacral Insufficiency Fractures. Spine 2009;15;34(4):309-315.

  6. Pommersheim W, Huang-Hellinger F, Baker M, Morris P. Sacroplasty: A Treatment for Sacral Insifficiency Fractures. Am J Neuroradiol 2003;24(5):1003-1007.

  7. Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, et al. A Randomized Controlled Trial of Vertebroplasty for Osteoporotic Spinal Fractures. N Engl J Med 2009;361(6):569-579.

  8. Esses SI, McGuire R, Jenkins J, Finkelstein J, Woodard E, Watters WC 3rd, et al. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg 2011;19(3):176-182.

  9. Klazen CAH, Lohle PNM, De Vries J, Jansen FH, Tielbeek AV, Blonk MC, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open- label randomised trial. Lancet 2010;25;376(9746):1085-1092.

  10. Edidin AA, Ong KL, Lau E, Kurtz SM. Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. Journal of Bone and mineral Research 2011;26(7):1617-1626.

  11. Layton KF, Thielen KR, Wald JT. Percutaneus Sacroplasty Using CT Fluoroscopy. Am J Neuroradiol 2006;27(2):356-358.

  12. Grossterlinden L, Begemann PGC, Lehmann.W, Nuechtern J, Schumacher U, Nagel HD, et al. Sacroplasty in a cadaveric trial: comparision of CT and fluroscopic guidance with and without ballon assistence. Eur Spine J 2009;18(8):1226-1233.

  13. Zhang J, Chun-gen W, Yi-feng G, Ming-hua L. Percutaneous Sacroplasty for Sacral Metastasic Tumors Under Fluoroscopic Guidance Only. Korean J Radiol 2008;9(6):572-576.

  14. Gordon HD, Nottmeir EW. Ballon kyphoplasty for treatment of sacral insufficiency fractures: Report of three cases. Neurosurg Focus 2005;18(3):1-5.

  15. Smith DK, Dix JE. Percutaneous Sacroplasty: Long-Axis Injection Technique. AJR 2006;186(5):1252-1255.

  16. Kemal A, Burack G, Kaya E, Kuku I, Harma A. Interpedicular Approach in Percutaneous Sacroplastyu for Treatment of Sacral Vertebral Body Pathologic Fractures. Cardiovasc Intervent Radiol 2011;34(Suppl 2):S282-S287.

  17. Bayley E, Srinivas S, Boszczyk BM. Clinical outcomes of sacroplasty in sacral insufficiency fractures: a review of the literature. Eur Spine J 2009;18(9):1266-1271.

  18. Garant M. Sacroplasty: A New Treatment for Sacral Insufficiency Fracture. J Vasc Interv Radiol 2002;13(12):1265-1267.

  19. Butler CL, Given II CA, Michel SJ, Tibbs PA. Percutaneous Sacroplasty for the Treatment of Sacral Insufficiency Fractures. Am Roentgenol 2005;184(6):1956-1959.

  20. Brook AL, Mirsky DM, Bello JA. Computerized Tomography Guided Sacroplasty: A Practical Treatment for Sacral Insufficiency Fracture. Case Report. Spine 2005;30(15):E450-E454.

  21. Deen HG, Nottmeier EW. Ballon kyphoplasty for treatment of sacral insufficiency fractures. Report of three cases. Neurosurg Focus 2005;18(3):1-7.

  22. Binaghi S, Gubtern D, Schnyder P, Theumann N. A new, easy, fast, and safe method for CT-guided sacroplasty. Eur Radiol 2006;16(12):2875-2878.

  23. Heron J, Connell DA, James SLJ. CT-guided sacroplasty for the treatment of sacral insufficiency fractures. Clin Radiol 2007;62(11):1094-1100.

  24. Sciubba DM, Wolinsky JP, Than KD, Gokaslan ZL, Witham TF, Murphy KP. CT Fluoroscopically Guided Percutaneous Placement of Transiliosacral Rod for Sacral Insufficiency Fracture: Case Report and Technique. Am J Neuroradiol 2007;28(8):1451-1454.

  25. Strub WM, Hoffmann M, Ernst RJ, Bulas RV. Sacroplasty by CT and Fluoroscopic Guidance: Is the Procedure Right for Your Patient? Am J Neuroradiol 2007;28(1):38-41.

  26. Whitlow CT, Mussat-Whitlow BJ, Mattern CWT, Baker MD, Morris PP. Sacroplasty versus Vertebroplasty: Comparable Clinical Outcomes for the Treatment of Fracture-Related Pain. Am J Neuroradiol 2007;28(7):1266-1270.

  27. Frey ME, DePalma MJ, Cifu DX, Bhagia SM, Came W, Daitch JS. Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observacional pilot study. Spine J 2008;8(2):367-373.

  28. Gjertsen Ř, Schellhorn T, Nakstad PH. Fluroscopy-Guided Sacroplasty: Special Focus on Preoperative Planning from Three-Dimensional Computed Tomography. Acta Radiol 2008;49(9):1042-1048.

  29. Tjardes T, Paffrath T, Baethis H, Shafizadeh S, Steinhausen E, Steinbuechel T, et al. Computer assisted percutaneous placement of augmented iliosacral screws: a reasonable alternative to sacroplasty. Spine 2008;33(13):1497-1500.

  30. Bastian JD, Benneker LM, Seidel U, Heini P, Keel MJB. Sacroplasty: Technical Notes and Complications. Eur spine J 2010;19(Suppl 3):S299-S300.




2020     |     www.medigraphic.com