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Three-Dimensional C-Arm Computed Tomography-Guided Sacroplasty for the Treatment of Sacral Body Fracture

Kang, Sang-Soo, MD; Kim, Hyun-Cheul, MD; Park, Joon-Hee, MD; Hong, Sung-Jun, MD; Kim, Il-Seok, MD; Shin, Keun-Man, MD, PhD

doi: 10.1097/BRS.0b013e3181978fee
Case Report
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Study Design. Case report.

Objective. To report our results of a sacroplasty technique, using 3-dimensional C-arm CT for the treatment of sacral body fracture.

Summary of Background Data. Sacroplasty may provide symptomatic relief and hasten recovery in the treatment of sacral insufficiency fractures. To our knowledge, there is no case report in the literature describing the application of sacroplasty for the treatment of sacral body fracture. We present a case of patient who had percutaneous sacroplasty for sacral body fracture and sacral alar fracture under 3-dimensional C-arm CT guidance and discuss the clinical results and technical considerations.

Methods. The procedure included a standard prone positioning of the patient and the area to be treated was prepared in a strictly sterile manner, and a local anesthesia was used. After a small skin incision, an 11-gauge vertebroplasty needle was positioned at the entry point in the sacrum. Then, the needle was inclined, directed, and advanced from the posterior aspect to the anterior aspect of the sacral vertebral body. PMMA cement was incrementally introduced in 0.5 mL aliquots and the volume of PMMA cement injected was total 4 mL. Precise needle placement and PMMA cement injection was performed under the 3-dimensional C-arm CT system and the right sacral alar region was performed in a similar manner.

Results. There were no peri-procedural complications occurred and the patient experienced an immediate and substantial pain relief that was persistent during a 12-month follow-up.

Conclusions. 3-dimensional C-arm CT-guided sacroplasty is a safe, practical, and effective solution to treatment of sacral body fracture.

Sacroplasty for sacral body fracture and sacral insufficiency fracture under three-dimensional C-arm guidance allows a fast, safe, and precise placement of the needle and cement delivery into the fracture site that can provide early symptom relief.

From the Department of Anesthesiology and Pain Medicine, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.

Acknowledgment date: July 3, 2008. First revision date: September 21, 2008. Second revision date: October 6, 2008. Acceptance date: October 9, 2008.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Keun-Man Shin, MD, PhD, Department of Anesthesiology and Pain Medicine, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, 445 Gildong, Kangdong-gu, Seoul, Republic of Korea, 134-701; E-mail: kmshin1@yahoo.co.kr

© 2009 Lippincott Williams & Wilkins, Inc.