Sacral Insufficiency Fractures: Pathology, Management, and Outcomes

➢ Sacral insufficiency fractures are associated with high morbidity and mortality rates and are becoming increasingly prevalent in elderly patients with osteoporosis.➢ Prompt identification of these injuries and appropriate treatment for stable and unstable fractures can reduce patient morbidity.➢ The treatment of sacral insufficiency fractures depends on the severity of symptoms, which, in most cases, is associated with the degree of fracture instability. Treatment options include nonoperative measures, pharmacologic therapies, procedural treatments, and operative management.➢ Sacroplasty may be an effective procedural treatment for sacral insufficiency fractures, although there has been a lack of comparative studies, and complication types and rates are concerning.➢ Percutaneous posterior pelvic ring screws demonstrate stable fixation, allowing early patient mobilization. Standard posterior pelvic ring percutaneous fixation has high screw backout rates, although new implants may mitigate these complications.➢ There have been limited comparative data on outcomes following treatment of these injuries across procedural and operative techniques.