Skip to main content
Top
Published in: Skeletal Radiology 4/2011

01-04-2011 | Technical Report

Percutaneous sacroplasty with the use of C-arm flat-panel detector CT: technical feasibility and clinical outcome

Authors: Sung Eun Kang, Joon Woo Lee, Joo Hyung Kim, Kun Woo Park, Jin S. Yeom, Heung Sik Kang

Published in: Skeletal Radiology | Issue 4/2011

Login to get access

Abstract

Purpose

Sacroplasty for sacral insufficiency fractures (SIFs) has been performed mostly under computed tomography (CT) or fluoroscopy guidance. The purposes of this study are to describe technical tips and clinical outcomes of sacroplasty under C-arm flat panel detector CT (C-arm CT) guidance, and to compare the cement distributions shown on C-arm CT with those on multi-detector CT (MDCT).

Materials and Methods

This study consisted of patients who underwent sacroplasty for SIF using C-arm CT from May 2006 to May 2009. Technical success was assessed in terms of cement filling and leakage. Clinical outcome was assessed at short-term (less than 1 month) and long-term (more than 1 month) follow-up using a four-grade patient satisfaction scale: poor, fair, good, and excellent. After sacroplasty, all patients underwent MDCT and three radiologists compared MDCT images with C-arm CT images in consensus, focusing on the cement distribution and cement leakage.

Results

Sacroplasties were performed on both sacral alae in all 8 patients (male:female = 2:6, mean age = 76.9, range = 63–82). The technical success rate was 100%. At short-term follow up, 6 patients (87.5%) reported significant improvement. Five patients (62.5%) were available for long-term follow-up and all 5 patients reported a reduced pain and an improved ability to ambulate. Using MDCT as the standard of reference, the cement distribution was visualized equally well by C-arm CT.

Conclusion

Sacroplasty under C-arm CT showed excellent technical success and good clinical outcome. There was an excellent correlation between C-arm CT and MDCT in evaluating cement distribution and cement leakage.
Literature
1.
go back to reference De Smet A, Neff JR. Pubic and sacral insufficiency fractures: clinical course and radiologic findings. Am J Roentgenol. 1985;145(3):601–6. De Smet A, Neff JR. Pubic and sacral insufficiency fractures: clinical course and radiologic findings. Am J Roentgenol. 1985;145(3):601–6.
2.
go back to reference Tsiridis E, Upadhyay N, Giannoudis P. Sacral insufficiency fractures: current concepts of management. Osteoporos Int. 2006;17(12):1716–25.PubMedCrossRef Tsiridis E, Upadhyay N, Giannoudis P. Sacral insufficiency fractures: current concepts of management. Osteoporos Int. 2006;17(12):1716–25.PubMedCrossRef
3.
go back to reference Lourie H. Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly. JAMA. 1982;248(6):715–7.PubMedCrossRef Lourie H. Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly. JAMA. 1982;248(6):715–7.PubMedCrossRef
4.
go back to reference Butler CL, Given CA II, Michel SJ, Tibbs PA. Percutaneous sacroplasty for the treatment of sacral insufficiency fractures. Am J Roentgenol. 2005;184(6):1956–9. Butler CL, Given CA II, Michel SJ, Tibbs PA. Percutaneous sacroplasty for the treatment of sacral insufficiency fractures. Am J Roentgenol. 2005;184(6):1956–9.
6.
go back to reference Kamel E, Binaghi S, Guntern D, Mouhsine E, Schnyder P, Theumann N. Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures. Eur Radiol. 2009;19(12):3002–7.CrossRef Kamel E, Binaghi S, Guntern D, Mouhsine E, Schnyder P, Theumann N. Outcome of long-axis percutaneous sacroplasty for the treatment of sacral insufficiency fractures. Eur Radiol. 2009;19(12):3002–7.CrossRef
7.
go back to reference Strub WM, Hoffmann M, Ernst RJ, Bulas RV. Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient? AJNR Am J Neuroradiol. 2007;28(1):38–41.PubMed Strub WM, Hoffmann M, Ernst RJ, Bulas RV. Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient? AJNR Am J Neuroradiol. 2007;28(1):38–41.PubMed
8.
go back to reference Whitlow CT, Mussat-Whitlow BJ, Mattern CWT, Baker MD, Morris PP. Sacroplasty versus vertebroplasty: comparable clinical outcomes for the treatment of fracture-related pain. AJNR Am J Neuroradiol. 2007;28(7):1266–70.PubMedCrossRef Whitlow CT, Mussat-Whitlow BJ, Mattern CWT, Baker MD, Morris PP. Sacroplasty versus vertebroplasty: comparable clinical outcomes for the treatment of fracture-related pain. AJNR Am J Neuroradiol. 2007;28(7):1266–70.PubMedCrossRef
10.
go back to reference Racadio JM, Babic D, Homan R, Rampton JW, Patel MN, Racadio JM, et al. Live 3D guidance in the interventional radiology suite. Am J Roentgenol. 2007;189(6):W357–64.CrossRef Racadio JM, Babic D, Homan R, Rampton JW, Patel MN, Racadio JM, et al. Live 3D guidance in the interventional radiology suite. Am J Roentgenol. 2007;189(6):W357–64.CrossRef
12.
go back to reference Kannus P, Palvanen M, Parkkari J, Niemi S, Järvinen M. Osteoporotic pelvic fractures in elderly women. Osteoporos Int. 2005;16(10):1304–5.PubMedCrossRef Kannus P, Palvanen M, Parkkari J, Niemi S, Järvinen M. Osteoporotic pelvic fractures in elderly women. Osteoporos Int. 2005;16(10):1304–5.PubMedCrossRef
13.
go back to reference Garant M. Sacroplasty: a new treatment for sacral insufficiency fracture. J Vasc Interv Radiol. 2002;13(12):1265–7.PubMedCrossRef Garant M. Sacroplasty: a new treatment for sacral insufficiency fracture. J Vasc Interv Radiol. 2002;13(12):1265–7.PubMedCrossRef
14.
go back to reference Pommersheim W, Huang-Hellinger F, Baker M, Morris P. Sacroplasty: a treatment for sacral insufficiency fractures. AJNR Am J Neuroradiol. 2003;24(5):1003–7.PubMed Pommersheim W, Huang-Hellinger F, Baker M, Morris P. Sacroplasty: a treatment for sacral insufficiency fractures. AJNR Am J Neuroradiol. 2003;24(5):1003–7.PubMed
15.
go back to reference Brook AL, Mirsky DM, Bello JA. Computerized tomography guided sacroplasty: a practical treatment for sacral insufficiency fracture: case report. Spine. 2005;30(15):E450–4.PubMedCrossRef Brook AL, Mirsky DM, Bello JA. Computerized tomography guided sacroplasty: a practical treatment for sacral insufficiency fracture: case report. Spine. 2005;30(15):E450–4.PubMedCrossRef
16.
go back to reference Smith DK, Dix JE. Percutaneous sacroplasty: long-axis injection technique. Am J Roentgenol. 2006;186(5):1252–5.CrossRef Smith DK, Dix JE. Percutaneous sacroplasty: long-axis injection technique. Am J Roentgenol. 2006;186(5):1252–5.CrossRef
17.
go back to reference Layton KF, Thielen KR, Wald JT. Percutaneous sacroplasty using CT fluoroscopy. AJNR Am J Neuroradiol. 2006;27(2):356–8.PubMed Layton KF, Thielen KR, Wald JT. Percutaneous sacroplasty using CT fluoroscopy. AJNR Am J Neuroradiol. 2006;27(2):356–8.PubMed
18.
go back to reference Hiwatashi A, Yoshiura T, Noguchi T, Togao O, Yamashita K, Kamano H, et al. Usefulness of cone-beam CT before and after percutaneous vertebroplasty. Am J Roentgenol. 2008;191(5):1401–5.CrossRef Hiwatashi A, Yoshiura T, Noguchi T, Togao O, Yamashita K, Kamano H, et al. Usefulness of cone-beam CT before and after percutaneous vertebroplasty. Am J Roentgenol. 2008;191(5):1401–5.CrossRef
19.
go back to reference Binaghi S, Guntern D, Schnyder P, Theumann N. A new, easy, fast, and safe method for CT-guided sacroplasty. Eur Radiol. 2006;16(12):2875–8.PubMedCrossRef Binaghi S, Guntern D, Schnyder P, Theumann N. A new, easy, fast, and safe method for CT-guided sacroplasty. Eur Radiol. 2006;16(12):2875–8.PubMedCrossRef
20.
go back to reference Whitlow C, Yazdani S, Reedy M, Kaminsky S, Berry J, Morris P. Investigating sacroplasty: technical considerations and finite element analysis of polymethylmethacrylate infusion into cadaveric sacrum. AJNR Am J Neuroradiol. 2007;28(6):1036.PubMedCrossRef Whitlow C, Yazdani S, Reedy M, Kaminsky S, Berry J, Morris P. Investigating sacroplasty: technical considerations and finite element analysis of polymethylmethacrylate infusion into cadaveric sacrum. AJNR Am J Neuroradiol. 2007;28(6):1036.PubMedCrossRef
Metadata
Title
Percutaneous sacroplasty with the use of C-arm flat-panel detector CT: technical feasibility and clinical outcome
Authors
Sung Eun Kang
Joon Woo Lee
Joo Hyung Kim
Kun Woo Park
Jin S. Yeom
Heung Sik Kang
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 4/2011
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-010-0959-4

Other articles of this Issue 4/2011

Skeletal Radiology 4/2011 Go to the issue