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European Spine Journal

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13-11-2023 | Osteoporosis | Original Article

Sacral insufficiency fracture: a single-center experience of 185 patients with a minimum 5-year follow-up

Authors: Buse Sarigul, Ahmet Ogrenci, Mesut Yilmaz, Orkun Koban, Mazhar Mammadov, Sedat Dalbayrak

Published in: European Spine Journal | Issue 4/2024

Abstract

Purpose

Sacral insufficiency fracture (SIF) is a commonly underdiagnosed etiology of back pain, especially in the geriatric and osteoporotic population. In this clinical study, we present our experience of 185 patients who were diagnosed with SIF and managed either with conservative or surgical treatment with a minimum 5-year follow-up.

Materials and method

Patients who were diagnosed with SIF, managed either conservatively or surgically, and had a minimum 5-year follow-up medical record were included in this study. CT scans and MR imaging including coronal STIR sequence were obtained from all. Bone densitometry (DEXA) was performed to detect accompanying osteopenia or osteoporosis. Patients were treated either conservatively or surgically. VAS and ODI scores were evaluated prior to the treatment and 1st day, 10th day, 3rd month, and 1st year postoperatively.

Results

The mean age of 185 patients was 69.2 and the mean follow-up period was 7.23 years (range: 5–11 years). 46 (24.9%) patients had a previous spinal or spinopelvic surgery and spinal instrumentation was implemented in 22(11.89%) of them. The time interval between the fusion surgery and the diagnosis of SIF was approximately 9.48 weeks. The fracture line could be detected with the MRI in 164 patients and with the CT in 177 patients. The fracture was bilateral in 120 (64.8%) patients. 102 patients were treated conservatively, and 83 received sacroplasty. VAS and ODI scores showed better improvement in pain and functionality in the surgical management group than in the conservative management group.

Conclusion

SIF should be considered in the differential diagnosis of back and pelvic pain, especially in elderly and osteoporotic patients. MRI with coronal STIR imaging should be a standard protocol for patients with a risk of SIF. Our results show that sacroplasty provides better and faster pain relief and recovery than conservative management.

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Title: Sacral insufficiency fracture: a single-center experience of 185 patients with a minimum 5-year follow-up
Authors: Buse Sarigul
Ahmet Ogrenci
Mesut Yilmaz
Orkun Koban
Mazhar Mammadov
Sedat Dalbayrak
Publication date: 13-11-2023
Publisher: Springer Berlin Heidelberg
Keywords: Osteoporosis
Osteoporosis
Back Pain
Back Pain
Back Pain
Published in: European Spine Journal / Issue 4/2024
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-08027-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sacral insufficiency fracture: a single-center experience of 185 patients with a minimum 5-year follow-up

Abstract

Purpose

Materials and method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and method

Results

Conclusion

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