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Related Experiment Videos

Osteoporotic sacral fractures: a clinical study.

C E Rawlings1, R H Wilkins, S Martinez

  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina.

Neurosurgery
|January 1, 1988
PubMed
Summary

Osteoporotic sacral insufficiency fractures, often missed on initial X-rays, present as low back pain in elderly women. Medical management effectively relieved pain in most patients, highlighting the importance of advanced imaging for diagnosis.

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Area of Science:

  • Orthopedics
  • Geriatrics
  • Radiology

Background:

  • Traumatic sacral fractures are linked to severe accidents and associated injuries.
  • Osteoporotic sacral insufficiency fractures are a subtler type, often presenting as low back pain in the elderly, particularly postmenopausal Caucasian women.
  • These fractures may be overlooked without advanced imaging techniques.

Purpose of the Study:

  • To describe the clinical features, treatment, and outcomes of osteoporotic sacral fractures.
  • To investigate the diagnostic utility of various imaging modalities for these fractures.

Main Methods:

  • Retrospective review of medical charts and radiological studies of 16 patients (13 women, 3 men) with osteoporotic sacral fractures.
  • Analysis of presenting symptoms, physical findings, diagnostic imaging (plain roentgenograms, sacral tomography, computed tomography, radionuclide bone scans), and treatment outcomes.

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Main Results:

  • The average patient age was 71 years, with all patients being Caucasian.
  • Common symptoms included diffuse low back pain, hip, buttock, or thigh pain, with physical findings limited to sacral tenderness and reduced low back motion.
  • Plain roentgenograms often failed to detect the fractures, while sacral tomography, computed tomography, and radionuclide bone scans were effective diagnostic tools.
  • Medical treatment focused on pain reduction and managing osteopenia, resulting in complete pain relief for 11 patients and substantial relief for 2 others.

Conclusions:

  • Osteoporotic sacral insufficiency fractures require advanced imaging for accurate diagnosis.
  • Medical management, including pain relief and osteopenia treatment, is effective in managing these fractures.
  • These fractures are a significant cause of low back pain in the elderly, especially Caucasian women.