L. Grossterlinden, P. G. C. Begemann, W. Lehmann, J. Nuechtern, U. Schumacher, H. D. Nagel, W. Linhart, G. Adam, J. M. Rueger, D. Briem


August 2009, Volume 18, Issue 8, pp 1226 - 1233 Original Article Read Full Article 10.1007/s00586-009-1001-1

First Online: 22 April 2009

Sacral insufficiency fractures can cause severe, debilitating pain to patients concerned. The incidence of this fracture type correlates with the appearance of osteoporosis in the elderly population. A polymethylmethacrylate (PMMA) cement injection procedure called sacroplasty has been recently described as an optional method for the treatment of this fracture type. However, the correct cement placement in the complex anatomical structure of the sacrum is a surgical challenge. The aim of the study is to compare the precision, safety, and radiation exposure of standard multiplanar fluoroscopy and computed tomography (CT) guidance for PMMA application to the sacrum using both balloon-assisted sacroplasty and conventional sacroplasty. A controlled experimental investigation in a human cadaver trial has been performed. Two imaging and two application modalities to monitor percutaneous PMMA injection to the sacrum were examined. The application forms were randomized from side to side of the pelvis. We found less cement extravasation in the CT-guided groups, but also a significant higher radiation exposure (P 


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