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B-1154 - Balloon sacroplasty (BSP), radiofrequency sacroplasty (RFS), vertebrosacroplasty (VSP) and cement sacroplasty (CSP) for the treatment of insufficiency fractures

R. Andresen1, S. Radmer2, J. Andresen3, H. Schober4; 1 Heide/DE 2 Berlin/DE 3 Vienna/AT 4 Rostock/DE Type: Scientific Paper
Area of Interests: Musculoskeletal spine, Neuroradiology spine, Interventional non-vascular
Imaging Technique: CT
Procedures: Technical aspects, Safety, Vertebroplasty
Special Focus: Osteoporosis
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Purpose: In elderly patients with reduced bone quality who experience suddenly occurring deep-seated low back pain, the possible presence of an insufficiency fracture in the sacrum should be considered as a differential diagnosis (1, 2). These fractures usually take a vertical course and are classified into [...]

Methods and materials: After an initial conservative treatment over a period of 3 weeks did not bring any satisfactory reduction of the severe, disabling pain, CT-guided cement augmentation was performed by means of BSP, RFS, VSP or CSP in 80 patients with a total of 122 sacral fractures. The patients were informed about [...]

Results: BSP, RFS, VSP and CSP were technically fully feasible in all patients. An average of 6.4 ml cement per fracture were inserted in the BSP group, 6.2 ml in the RFS group, 5.8 ml in the VSP group and 6 ml in the CSP group. Fig. 2a – d provides an example of the cement position in the respective fractur[...]

Conclusion: BSP, RFS, VSP and CSP are interventional, minimally invasive procedures that achieve equally good pain reduction over a period of 18 months. In the case of VSP and CSP, a higher rate of cement leakages is to be expected, which means that BSP and RFS represent the safer methods.

Personal information: Prof. Dr. med. habil. Reimer Andresen, Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany; randresen@wkk-hei.de Dr. med. Sebastian Radmer, Centre for Orthopaedic[...]

References: 1. Dasgupta B, Shah N, Brown H et al. Sacral insufficiency fractures: an unsuspected cause of low back pain. Br J Rheumatol 1998; 37 (7): 789-793. 2. Schindler OS, Watura R, Cobby M. Sacral insufficiency fractures. J Orthopaedic Surg 2007; 15 (3): 339-346. 3. Denis F, Davis S, Comfort T. Sacral frac[...]

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