Complications related to cement leakage in sacroplasty.

Data concerning the safety of sacroplasty in terms of cement leakage is scarce. Frequency, distribution patterns and clinical consequences of cement leakage were assessed in 33 patients (28 female, mean age: 74 +/- 10 yrs; bilateral SIF: n = 30, 63 sacroplasties) treated with sacroplasty between 06/2003 and 11/2010 in a retrospective study using patients' records, operative notes and postoperative radiographs. Cement leakage was noted within the fracture gap (27%), into veins (6%), neuroforamina (3%) or in the intervertebral disc space L5/S1 (2%). In one patient, cement leakage into the fracture gap led to unilateral radiculopathy of the 5th lumbar nerve root. Leakage into the fracture gap is at high risk of affecting the 5th lumbar nerve root due to the special course of its ventral branch over the sacral promontory. The risks of cement leakage with neurological impairment should be explained to patients.

[1]  B. Boszczyk,et al.  Clinical outcomes of sacroplasty in sacral insufficiency fractures: a review of the literature , 2009, European Spine Journal.

[2]  P. Heini,et al.  Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements , 2009, European Spine Journal.

[3]  N. Crawford,et al.  Anatomical and Biomechanical Analyses of the Unique and Consistent Locations of Sacral Insufficiency Fractures , 2009, Spine.

[4]  D. Cifu,et al.  Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study. , 2008, The spine journal : official journal of the North American Spine Society.

[5]  S. James,et al.  CT-guided sacroplasty for the treatment of sacral insufficiency fractures. , 2007, Clinical radiology.

[6]  J. Dix,et al.  Percutaneous sacroplasty: long-axis injection technique. , 2006, AJR. American journal of roentgenology.

[7]  C. Slipman,et al.  Sacral stress fractures , 2006, Current sports medicine reports.

[8]  R. Hilgert,et al.  [Technique for percutaneous iliosacral screw insertion with conventional C-arm radiography]. , 2005, Der Unfallchirurg.

[9]  P. Kannus,et al.  Osteoporotic pelvic fractures in elderly women , 2005, Osteoporosis International.

[10]  C. Given,et al.  Percutaneous sacroplasty for the treatment of sacral insufficiency fractures. , 2005, AJR. American journal of roentgenology.

[11]  H. G. Deen,et al.  Balloon kyphoplasty for treatment of sacral insufficiency fractures. Report of three cases. , 2005, Neurosurgical focus.

[12]  E. Chao,et al.  Biomechanical considerations of fracture treatment and bone quality maintenance in elderly patients and patients with osteoporosis. , 2004, Clinical orthopaedics and related research.

[13]  M Bohner,et al.  Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. , 2003, Biomaterials.

[14]  F. Huang-Hellinger,et al.  Sacroplasty: a treatment for sacral insufficiency fractures. , 2003, AJNR. American journal of neuroradiology.

[15]  M. Garant Sacroplasty: a new treatment for sacral insufficiency fracture. , 2002, Journal of vascular and interventional radiology : JVIR.

[16]  W. Nagler,et al.  Sacral insufficiency fractures: a report of two cases and a review of the literature. , 2001, Journal of women's health & gender-based medicine.

[17]  P. Heini,et al.  Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results , 2000, European Spine Journal.

[18]  W. Nagler,et al.  The controversy surrounding sacral insufficiency fractures: to ambulate or not to ambulate? , 2000, American journal of physical medicine & rehabilitation.

[19]  M. Järvinen,et al.  Epidemiology of Osteoporotic Pelvic Fractures in Elderly People in Finland: Sharp Increase in 1970–1997 and Alarming Projections for the New Millennium , 2000, Osteoporosis International.

[20]  I. Portek,et al.  Sacral insufficiency fractures in the elderly. , 1994, The Journal of bone and joint surgery. British volume.

[21]  J. Matta,et al.  Prevention of deep vein thrombosis and pulmonary embolism in acetabular and pelvic fracture surgery. , 1994, Clinical orthopaedics and related research.

[22]  M. McCarthy,et al.  Risk of pulmonary emboli in patients with pelvic fractures. , 1993, The American surgeon.

[23]  F. Denis,et al.  Sacral fractures: an important problem. Retrospective analysis of 236 cases. , 1988, Clinical orthopaedics and related research.

[24]  C. Mazel,et al.  Transverse Fracture of the Upper Sacrum: Suicidal Jumper's Fracture , 1985, Spine.

[25]  H. Lourie Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly. , 1982, JAMA.

[26]  A. Chobanian,et al.  The Metabolic and Hemodynamic Effects of Prolonged Bed Rest in Normal Subjects , 1974, Circulation.