Percutaneous Sacroplasty for Sacral Insufficiency Fractures; A Safe Procedure with Good Clinical Outcomes: A Retrospective Study

Introduction:
Sacral insufficiency fractures, represent a well know entity, with an increased incidence annually, affecting the elderly population with osteoporosis and oncology patients causing severe low back pain and immobilization in this fragile population. The care of these patients represent a real challenge, with no short term resolution in pain or mobility.

We here assess the efficacy and safety of sacroplasty in reducing pain in this population.

Methods:
We performed a retrospective review of our databases for percutaneous sacroplasty, performed between October 2018 and April 2021. Demographic, etiology, Visual Analog Scale pre and post procedure, days of hospitalization, ability of ambulate after procedure and radiological outcome were collected.

Results:
Fifty-six patients were operated between, October 2018 and April 2021, 47 (83.9%) were female and 11 (16.07) males. The average age was 78.25 years old (55-96). 20 (35.7%) oncological patients 36 (64.28%) osteoporotic related fractures. The mean VAS score pre procedure was 8.92 (range from 6 to 10), at two weeks follow up post procedure, the mean VAS was 1.35, (rage from 1 to 4), There was a statistically significant decreases in the Visual Analog Scale, (p=0.0015). All patients were on narcotics prior to surgery and stopped it after discharge.

There was no neurological complication for any of the patients. One patient presented mechanical failure, that underwent sacral fixation surgery two weeks after the sacroplasty with a iliosacral screw. All patients were discharged ambulating, with and average of hospitalization days of 2.8 days (1 to 17 days), and average time of discharge after procedure of 1,2 days (1 to 7 days)

Conclusions:
Percutaneous Sacroplasty is a safe, and an effective procedure providing great pain relief, decreasing the amount of pain medications consumed, increasing mobility in this frail population. With and short hospitalization rate.