Safety and effectiveness of percutaneous sacroplasty: a single-centre experience in 58 consecutive patients with tumours or osteoporotic insufficient fractures treated under fluoroscopic guidance

Objective

To report our experience in percutaneous sacroplasty (PSP) for tumours and insufficiency fractures of the sacrum.

Methods

Single-centre retrospective analysis of 58 consecutive patients who underwent 67 PSPs for intractable pain from sacral tumours (84.5 %) or from osteoporotic fractures (15.5 %). The following data were assessed: visual analogue scale (VAS) before and after the procedure for global pain; short-term (1-month) clinical follow-up using a four-grade patient satisfaction scale (worse, unchanged, mild improvement and significant improvement); modification in analgesics consumption; referred short-term walking mobility. Minor and major complications were systematically assessed.

Results

The mean VAS score was 5.3?±?2.0 in pre-procedure and 1.7?±?1.8 in post-procedure. At 1-month follow-up, 34/58 (58.5 %) patients experienced a mild improvement; 15/58 (26 %) presented a significant improvement while 4/58 (7 %) and 5/58 (8.5 %) patients had unchanged or worse pain, respectively. Decreased analgesic consumption was observed in 34 % (20/58) of the patients. Eighty percent of patients with walking limitation experienced improvement, 16 % remained unchanged and 4 % were worse. We noted minor complications in 2/58 patients (3.4 %) and major complications in 2/58 patients (3.4 %).

Conclusion

Percutaneous sacroplasty for metastatic and osteoporotic fractures is a safe and effective technique in terms of pain relief and functional outcome.

Key points

? Percutaneous sacroplasty provides pain relief and functional improvement for insufficiency sacral fractures. ? Percutaneous sacroplasty provides pain relief and function improvement for sacral tumours. ? The major complication rate is acceptable (3.4 %), and is higher in sacral tumours. ? Posterior wall/cortical sacral bone disruption is not statistically associated with more complications. ? However, osteolytic tumours seem to be associated with higher risk of complications.