A C Gupta1, R V Chandra2, A J Yoo1, T M Leslie-Mazwi1, D L Bell1, B P Mehta1, T L Vanderboom1, J D Rabinov1, M Larvie1, J A Hirsch3. 1. From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia. 3. From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts jahirsch@partners.org jahirsch@mgh.harvard.edu.
Abstract
BACKGROUND AND PURPOSE: Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment. MATERIALS AND METHODS: We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up. RESULTS: Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale (P < .001), Functional Mobility Scale (P < .001), and Analgesic Scale scores (P < .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0-10.0]); Functional Mobility Scale, 3.0 (2.0-3.0); and Analgesic Scale scores, 3.0 (3.0-4.0) were reduced to 3.0 (0.0-5.8), 1.0 (0.25-2.8), and 3.0 (2.0-3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% (n = 45) reported complete resolution or improvement in overall pain. CONCLUSIONS: In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.
BACKGROUND AND PURPOSE:Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment. MATERIALS AND METHODS: We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up. RESULTS: Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale (P < .001), Functional Mobility Scale (P < .001), and Analgesic Scale scores (P < .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0-10.0]); Functional Mobility Scale, 3.0 (2.0-3.0); and Analgesic Scale scores, 3.0 (3.0-4.0) were reduced to 3.0 (0.0-5.8), 1.0 (0.25-2.8), and 3.0 (2.0-3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% (n = 45) reported complete resolution or improvement in overall pain. CONCLUSIONS: In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.
Authors: Amar C Gupta; Albert J Yoo; Jeffrey Stone; John C Barr; Allan Brook; Sean Tutton; Orlando Ortiz; Ariel E Hirsch; Mykol Larvie; Michael E Frey; Mahesh V Jayaraman; Joshua A Hirsch Journal: J Neurointerv Surg Date: 2011-10-15 Impact factor: 5.836
Authors: Amar C Gupta; Joshua A Hirsch; Zeshan A Chaudhry; Ronil V Chandra; Benjamin Pulli; Janice G Galinsky; Ariel E Hirsch; Albert J Yoo Journal: J Neurointerv Surg Date: 2011-04-06 Impact factor: 5.836
Authors: Michael E Frey; Michael J Depalma; David X Cifu; Sarjoo M Bhagia; William Carne; Jonathan S Daitch Journal: Spine J Date: 2007-07-20 Impact factor: 4.166
Authors: Ryne W Dougherty; Jennifer S McDonald; Yong Woon Cho; John T Wald; Kent R Thielen; David F Kallmes Journal: J Neurointerv Surg Date: 2013-01-23 Impact factor: 5.836
Authors: Ivan Urits; Vwaire Orhurhu; Jessica Callan; Nishita V Maganty; Sara Pousti; Thomas Simopoulos; Cyrus Yazdi; Rachel J Kaye; Lauren K Eng; Alan D Kaye; Laxmaiah Manchikanti; Omar Viswanath Journal: Curr Pain Headache Rep Date: 2020-02-17
Authors: Dawn van Berkel; Terence Ong; Avril Drummond; Paul Hendrick; Paul Leighton; Matthew Jones; Khalid Salem; Nasir Quraishi; Cassandra Brookes; Ana Suazo Di Paola; Sarah Edwards; Opinder Sahota Journal: BMJ Open Date: 2019-07-10 Impact factor: 2.692
Authors: D Schwetje; Y El Sayed Hassan Wahd; R Bornemann; T R Jansen; R Pflugmacher; A Kasapovic Journal: Sci Rep Date: 2020-10-28 Impact factor: 4.379