Related Experiment Video
Updated: Jul 1, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
A biomechanical comparison of lateral and posterior approaches to sacroplasty
Matthew D Waites1, Simon C Mears, Andrew M Richards
1International Center for Orthopaedic Advancement, Department of Orthopaedic Surgery, The Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
Study Design:
Biomechanical cadaveric bench study.
Objective:
To measure the augmentation effect and extravasation risk of posterior and lateral approaches to sacroplasty.
Summary Of Background Data:
The biomechanical stabilizing effect of sacroplasty is unknown.
Methods:
Using a sacral insufficiency fracture model, we performed sacroplasty in 15 osteoporotic cadaveric pelves. Five served as controls, and 10 were each injected with 4 mL of a polymethylmethacrylate cement (5 via a posterior approach, 5 via a lateral approach). Cement extravasation was assessed using computed tomography. Restored strength and stiffness were defined as the ratios of treatment to initial strength and to stiffness, respectively. Between-group differences in restoration parameters were checked for significance (P < 0.05) using an analysis of variance followed by Tukey's test.
Results:
We found no significant differences between groups in terms of restored strength ( approximately 61%) and stiffness ( approximately 77%). Both injection methods produced extravasation into the anterior sacrum, the posterior sacrum, the sacroiliac joint, and the neural foramens.
Conclusion:
Sacroplasty with 4 mL of cement does not restore the strength or stiffness of the sacrum in a cadaveric model, regardless of the approach used.
