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CT-/X-Ray-Guided Augmentation Techniques in Sacrococcygeal Spine Augmentation

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Vertebral Lesions

Part of the book series: New Procedures in Spinal Interventional Neuroradiology ((NPSIN))

Abstract

Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Diagnosis is often delayed due to the relative insensitivity of conventional radiography. Current management options range from analgesia and physical therapy to surgical fixation. Advances in interventional neuroradiological techniques using sacroplasty have resulted in a safe and effective percutaneous treatment option for patients with minimal associated morbidity. Recently, coccygeoplasty for treating coccyx subluxation/fracture has been described.

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References

  1. Lourie H. Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly. JAMA. 1982;248(6):715–7. doi:10.1103/PhysRevD.15.2752.

    Article  CAS  PubMed  Google Scholar 

  2. Leroux JL, Denat B, Thomas E, Blotman F, Bonnel F. Sacral insufficiency fractures presenting as acute low-back pain. Biomechanical aspects. Spine. 1993;18(16):2502–6.

    Article  CAS  PubMed  Google Scholar 

  3. Grasland A. Sacral insufficiency fractures. Arch Intern Med. 1996;156(6):668. doi:10.1001/archinte.1996.00440060096012.

    Article  CAS  PubMed  Google Scholar 

  4. Finiels H, Finiels PJ, Jacquot JM, Strubel D. Fractures of the sacrum caused by bone insufficiency. Meta-analysis of 508 cases. Presse Med. 1997;26(33):1568–73.

    CAS  PubMed  Google Scholar 

  5. Lin J, Lachmann E, Nagler W. Sacral insufficiency fractures: a report of two cases and a review of the literature. J Womens Health Gend Based Med. 2001;10(7):699–705.

    Article  CAS  PubMed  Google Scholar 

  6. Hosey RG, Fernandez MM, Johnson DL. Evaluation and management of stress fractures of the pelvis and sacrum. Orthopedics. 2008;31(4):383–5.

    Article  PubMed  Google Scholar 

  7. Gupta AC, Yoo AJ, Stone J, et al. Percutaneous sacroplasty. J Neurointerv Surg. 2012;4(5):385–9. doi:10.1136/neurintsurg-2011-010136.

    Article  PubMed  Google Scholar 

  8. Diel J, Ortiz O, Losada RA, Price DB, Hayt MW, Katz DS. The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach 1. Radiographics. 2001;21(1):83–104. doi:10.1148/radiographics.21.1.g01ja0883.

    Article  CAS  PubMed  Google Scholar 

  9. Ahovuo JA, Kiuru MJ, Visuri T. Fatigue stress fractures of the sacrum: diagnosis with MR imaging. Eur Radiol. 2004;14(3):500–5. doi:10.1007/s00330-003-1989-2.

    Article  PubMed  Google Scholar 

  10. Blake SP, Connors AM. Sacral insufficiency fracture. Br J Radiol. 2014; doi:10.1259/bjr/81974373;issue:issue:10.1259/bjr.2004.77.issue-922;page:string:Article/Chapter.

    Google Scholar 

  11. Lyders EM, Whitlow CT, Baker MD, Morris PP. Imaging and treatment of sacral insufficiency fractures. Am J Neuroradiol. 2010;31(2):201–10. doi:10.3174/ajnr.A1666.

    Article  CAS  PubMed  Google Scholar 

  12. Galbraith JG, Butler JS, Blake SP, Kelleher G. Sacral insufficiency fractures: an easily overlooked cause of back pain in the ED. Am J Emerg Med. 2011;29(3):359.e5–6. doi:10.1016/j.ajem.2010.04.015.

    Article  Google Scholar 

  13. Jensen ME, McGraw JK, Cardella JF, Hirsch JA. Position statement on percutaneous vertebral augmentation: a consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology. 2007;18:325–30. doi:10.1016/j.jvir.2007.01.014.

  14. Pereira LP, Clarençon F, Cormier É, et al. Safety and effectiveness of percutaneous sacroplasty: a single-centre experience in 58 consecutive patients with tumours or osteoporotic insufficient fractures treated under fluoroscopic guidance. Eur Radiol. 2013;23(10):2764–72. doi:10.1007/s00330-013-2881-3.

    Article  PubMed  Google Scholar 

  15. Nebreda C, Vallejo R, Aliaga L, Benyamin R. Percutaneous sacroplasty and sacroiliac joint cementation under fluoroscopic guidance for lower back pain related to sacral metastatic tumors with sacroiliac joint invasion. Pain Pract. 2010:564–9. doi:10.1111/j.1533-2500.2010.00439.x.

  16. Naderi S, Ilaslan H, Aslan A, Koc ON, Dalkilic T. Sacroplasty: report of three cases. Turk Neurosurg. 2010;20(3):418–22. doi:10.5137/1019-5149.JTN.2676-09.3.

    PubMed  Google Scholar 

  17. Kortman K, Ortiz O, Miller T, et al. Multicenter study to assess the efficacy and safety of sacroplasty in patients with osteoporotic sacral insufficiency fractures or pathologic sacral lesions. J Neurointerv Surg. 2013;5(5):461–6. doi:10.1136/neurintsurg-2012-010347.

    Article  PubMed  Google Scholar 

  18. Kang SE, Lee JW, Kim JH, Park KW, Yeom JS, Kang HS. Percutaneous sacroplasty with the use of C-arm flat-panel detector CT: technical feasibility and clinical outcome. Skelet Radiol. 2010;40(4):453–60. doi:10.1007/s00256-010-0959-4.

    Article  Google Scholar 

  19. Frey ME, DePalma MJ, Cifu DX, Bhagia SM, Daitch JS. Efficacy and safety of percutaneous sacroplasty for painful osteoporotic sacral insufficiency fractures: a prospective, multicenter trial. Spine. 2007;32(15):1635–40. doi:10.1097/BRS.0b013e318074d4e1.

    Article  PubMed  Google Scholar 

  20. Choi K-M, Song J-H, Ahn S-K, Choi H-C. Therapeutic considerations of percutaneous sacroplasty for the sacral insufficiency fracture. J Korean Neurosurg Soc. 2010;47(1):58. doi:10.3340/jkns.2010.47.1.58.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Moussazadeh N, Laufer I, Werner T, et al. Sacroplasty for cancer-associated insufficiency fractures. Neurosurgery. 2015;76(4):446–50. doi:10.1227/NEU.0000000000000658.

    Article  PubMed  Google Scholar 

  22. Dougherty RW, McDonald JS, Cho YW, Wald JT, Thielen KR, Kallmes DF. Percutaneous sacroplasty using CT guidance for pain palliation in sacral insufficiency fractures. J Neurointerv Surg. 2014;6(1):57–60. doi:10.1136/neurintsurg-2012-010599.

    Article  PubMed  Google Scholar 

  23. Baran S, Hak DJ, Stahel PF, editors. Sacral fractures: current strategies in diagnosis and management. Orthopedics. 2009;32(10):752–7. doi:10.3928/01477447-20090818-18.

  24. Perkins R, Schofferman J, Reynolds J. Coccygectomy for severe refractory sacrococcygeal joint pain. J Spinal Disord Tech. 2003;16(1):100.

    Article  PubMed  Google Scholar 

  25. Fogel GR, Cunningham PYI, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12(1):49.

    Article  PubMed  Google Scholar 

  26. Nas OF, Kaçar E, Buyukkaya R, Şanal B, Erdogan C, Hakyemez B. Treatment of sacral aneurysmal bone cyst with percutaneous sacroplasty. Spine J. 2016;16(1):e1–2. doi:10.1016/j.spinee.2015.08.005.

    Article  PubMed  Google Scholar 

  27. Gupta AC, Chandra RV, Yoo AJ, et al. Safety and effectiveness of sacroplasty: a large single-center experience. Am J Neuroradiol. 2014;35(11):2202–6. doi:10.3174/ajnr.A4027.

    Article  CAS  PubMed  Google Scholar 

  28. Kamalian S, Bordia R, Ortiz AO. Post-vertebral augmentation back pain: evaluation and management. Am J Neuroradiol. 2012;33(2):370–5. doi:10.3174/ajnr.A2775.

    Article  CAS  PubMed  Google Scholar 

  29. Mathis JM, Deramond H, Belkoff SM, editors. Percutaneous vertebroplasty and kyphoplasty. New York: Springer; 2006. doi:10.1007/0-387-36083-2.

    Google Scholar 

  30. Ortiz AO, Natarajan V, Gregorius DR, Pollack S. Significantly reduced radiation exposure to operators during kyphoplasty and vertebroplasty procedures: methods and techniques. AJNR Am J Neuroradiol. 2006;27(5):989–94.

    CAS  PubMed  Google Scholar 

  31. Kortman K, Mathis JM, Ortiz AO. Sacroplasty. In: Mathis JM, Deramond H, Belkoff SM, editors. Percutaneous vertebroplasty and kyphoplasty. New York: Springer; 2006. p. 197–209. doi:10.1007/0-387-36083-2_12.

    Chapter  Google Scholar 

  32. Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine. 2001;26(14):1537–41.

    Article  CAS  PubMed  Google Scholar 

  33. Barber SM, Livingston AD, Cech DA. Sacral radiculopathy due to cement leakage from percutaneous sacroplasty, successfully treated with surgical decompression. J Neurosurg Spine. 2013;18(5):524–8. doi:10.3171/2013.2.SPINE12497.

    Article  PubMed  Google Scholar 

  34. Richards AM, Mears SC, Knight TA, Dinah AF, Belkoff SM. Biomechanical analysis of sacroplasty: does volume or location of cement matter? Am J Neuroradiol. 2009;30(2):315–7. doi:10.3174/ajnr.A1358.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Todd S. Miller & Allan L. Brook M.D.

  2. Massachussets General Hospital, Boston, MA, USA

    Joshua A. Hirsch M.D. & Ronil Chandra M.D.

  3. Clinical Professor of Radiology, State University of New York, Stony Brook, NY, USA

    A. Orlando Ortiz M.D., M.B.A.

  4. Department of Radiology, Winthrop-University Hospital, Mineola, NY, USA

    A. Orlando Ortiz M.D., M.B.A.

  5. Minimal Invasive Spine Therapy, Cannizzaro Hospital, Catania, Italy

    Luigi Manfrè M.D.

Authors
  1. Todd S. Miller
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  2. Allan L. Brook M.D.
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  3. Joshua A. Hirsch M.D.
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  4. Ronil Chandra M.D.
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  5. A. Orlando Ortiz M.D., M.B.A.
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  6. Luigi Manfrè M.D.
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Corresponding author

Correspondence to Todd S. Miller .

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Editors and Affiliations

  1. Minimal Invasive Spine Therapy, Cannizzaro Hospital, Catania, Italy

    Luigi Manfrè

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Miller, T.S., Brook, A.L., Hirsch, J.A., Chandra, R., Ortiz, A.O., Manfrè, L. (2017). CT-/X-Ray-Guided Augmentation Techniques in Sacrococcygeal Spine Augmentation. In: Manfrè, L. (eds) Vertebral Lesions. New Procedures in Spinal Interventional Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-52634-8_6

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  • DOI: https://doi.org/10.1007/978-3-319-52634-8_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52632-4

  • Online ISBN: 978-3-319-52634-8

  • eBook Packages: MedicineMedicine (R0)

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