Analgesic effect of sacroplasty in osteoporotic sacral fractures: A study of six cases

Abstract

ObjectivesTo evaluate the short-term analgesic effect of sacroplasty in patients with osteoporotic sacral fractures. MethodsSingle-center retrospective observational study of all patients managed with sacroplasty for osteoporotic sacral fractures between October 2008 and November 2009. For each patient, symptom duration, pain intensity, and analgesic consumption were recorded. Sacroplasty was performed under local analgesia, in the prone position, with computed tomography guidance. The long-axis approach was sued to introduce the needles and polymethylmethacrylate cement along the fracture line(s). Pain was evaluated on a 10-point visual analog scale (VAS) 24hours before sacroplasty then at the time of weight-bearing resumption 24hours after the procedure. Hospital stay length before and after the procedures were recorded. ResultsWe identified six patients (five women and one man) with a mean age of 83.2 years. All six patients presented with low back pain and four also had buttock pain. The interval from pain onset to diagnosis ranged from 1 month to 1 year. All patients reported that pain onset followed a fall. The mean VAS pain score was 8.2 before sacroplasty and decreased by 7.6 points 24hours after the procedure (with four patients having a score of 0). Mean hospital stay length were 12 days before and 4 days after sacroplasty. All patients required opioid analgesics before sacroplasty. At discharge, analgesic requirements were a step II analgesic in one patient, acetaminophen in one patient, and no analgesics in four patients. No adverse events were recorded. DiscussionThe findings from our small population are consistent with a recent literature review of 15 case-series studies showing a significant analgesic effect of sacroplasty. The rapid effect of sacroplasty allows prompt ambulation, thus avoiding complications related to immobility. ConclusionSacroplasty is effective in relieving pain due to sacral insufficiency fractures.