What are sacral insufficiency fractures?
Sacral insufficiency fractures are a common cause of lower back and pelvic pain in elderly patients. By definition, an insufficiency fracture occurs due to a normal level of stress on the bone. In these cases, the sacrum is most often weakened by osteoporosis, a common condition found in women after menopause. Several other processes, such as radiation or chronic steroid use, can also weaken the sacrum.
Diagnosis and symptoms
Sacral insufficiency fractures are notoriously hard to diagnose and can be a significant cause of prolonged recovery with loss of independence. Patients will often begin to find that they are unable to perform daily activities because of debilitating pain above their tailbone. Eventually, they will undergo a CT scan or MRI and be diagnosed with a sacral fracture. Left to heal by themselves, it can take weeks or months for patients to regain their self-sufficiency, and people may never return back to their baseline.
Sacroplasty is a minimally invasive technique for sacral insufficiency fractures
Sacroplasty is a minimally invasive procedure performed by an interventional radiologist, which can provide rapid pain relief and improved function. It is done in an office on an outpatient basis or in a hospital. A patient will undergo an x-ray procedure where a needle is directed into the areas of the sacrum that are fractured. Once in place, a cement-like paste is infused into the fracture to fixate it, and decrease the pain associated with instability. The recovery following the procedure is one hour.
Advantages of sacroplasty
Studies show significant clinical improvement in pain and function compared to watchful waiting for sacral insufficiency fractures. Pain is often cut in half in the first day or so following the procedure, continuing to improve in weeks and months thereafter. On average, the ability to discontinue and de-escalate pain medicine is also improved compared to non-surgical management.
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