[Balloonsacroplasty: C-arm or CT controlled application? : Experience with 46 patients]

Area of Science:

• Interventional Radiology
• Orthopedic Surgery
• Pain Management

Background:

• Sacral insufficiency fractures often cause severe pain and are frequently misdiagnosed.
• Magnetic resonance imaging (MRI) offers sensitive detection of these fractures.
• Sacroplasty, similar to balloon kyphoplasty, utilizes cement for fracture fixation.

Purpose of the Study:

• To evaluate the efficacy of sacroplasty in reducing pain associated with sacral insufficiency fractures.
• To compare the rates of cement extravasation and complications between computed tomography (CT)-guided and C-arm controlled sacroplasty.

Main Methods:

• A retrospective multicenter study involving 46 patients (average age 75 years) treated with sacroplasty.
• Procedures were performed using either CT-guidance (25 patients) or C-arm control (21 patients).
• Pain was assessed using a visual analog scale, with a 6-month follow-up period.

Main Results:

• Both CT-guided and C-arm controlled sacroplasty significantly reduced pain scores (p < 0.001).
• CT-guided sacroplasty demonstrated zero instances of cement extravasation (0%), while the C-arm group had 38% (8/21) asymptomatic extravasation.
• The C-arm group experienced two complications including superior gluteal artery injury requiring operative treatment.

Conclusions:

• Balloon sacroplasty provides reliable and significant pain relief for sacral insufficiency fractures.
• CT-guided cement application is associated with lower rates of cement extravasation and fewer complications than C-arm guided application.