Percutaneous Imaging-Guided Screw Fixation of Osteoporotic Transverse Fractures of the Lower Sacrum with Cement Augmentation: Report of 2 Cases

Cardiovasc Intervent Radiol. 2017 Jul;40(7):1105-1111. doi: 10.1007/s00270-017-1633-1. Epub 2017 Mar 29.

Abstract

Osteoporotic fractures of the sacrum usually involve the sacral ala and can be managed with percutaneous cementoplasty if conservative therapy failed to achieve bone consolidation. On the other hand, isolated transverse fractures of the lowest sacrum are more rare, with little literature focusing on their management in the osteoporotic population. If pseudoarthrosis occurs in this location, sacroplasty is not an optimal therapeutic option because of the poor biomechanical resistance of cement to multi-directional stresses. Hence, we report two cases of chronic unhealed transverse fractures of the lowest sacrum successfully managed with percutaneous image-guided screw fixation augmented with cement injection. At last follow-up available, both patients experienced complete pain relief, without evidences of failure of the osteosynthesis on CT-scan controls.

Keywords: Cementoplasty; Fracture; Sacrum; Screw fixation.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Bone Screws*
  • Cone-Beam Computed Tomography / methods
  • Female
  • Fracture Fixation, Internal / methods*
  • Fractures, Ununited / diagnostic imaging
  • Fractures, Ununited / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Osteoporotic Fractures / diagnostic imaging
  • Osteoporotic Fractures / surgery*
  • Sacrum / injuries*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Surgery, Computer-Assisted / methods*
  • Vertebroplasty / methods*