Andresen R, Radmer S, Kamusella P, Wissgott C, Banzer J, Schober H C
Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg., Heide
Rofo. 2012 Jan;184(1):32-6. doi: 10.1055/s-0031-1281782. Epub 2011 Oct 27.
In older patients with reduced bone quality, fatigue fractures of the os sacrum are relatively common and are typically accompanied by strong, disabling pain. The aim of our study was to verify the feasibility and safety of sacroplasty using a balloon catheter as well as the reduction of pain.
25 patients were diagnosed with an os sacrum fracture in MRI. As a manifestation of an extant bone reconstruction process, all patients were diagnosed with distinctive edema on the basis of MRI strong T 2-weighted images. CT-controlled balloon sacroplasty was performed in all patients. To allow the cement to be dispensed at a longitudinal angle to the fracture, the balloon catheter is directed through a hollow needle in the os sacrum either from the caudal to the cranial direction or from the craniodorsal to the caudoventral direction. The thus created cavity was then filled with PMMA cement. A control CT and a conventional X-ray in two planes were then carried out. The pain intensity was defined by means of VAS before the intervention, on the second day, and 6 and 12 months after the intervention.
The balloon sacroplasty yielded good technical performance in every patient. The control CT and the X-ray control of the os sacrum showed adequate distribution of the cement, and cement leakage was not detected. Before the operation, the average pain encountered was in accordance with VAS 8.3. On the second postoperative day, a considerable reduction with an average of 2.7 was reported, and this remained stable with an average of 2.5 after 6 and 12 months.
Balloon sacroplasty is an effective treatment method for fast pain relief in patients with fatigue fractures of the os sacrum.
在骨质下降的老年患者中，骶骨疲劳性骨折相对常见，通常伴有强烈的、致残性疼痛。我们研究的目的是验证使用球囊导管进行骶骨成形术的可行性和安全性以及疼痛减轻情况。
25例患者经MRI诊断为骶骨骨折。作为现有骨重建过程的一种表现，所有患者在MRI T2加权强图像的基础上被诊断为有明显水肿。所有患者均接受CT引导下球囊骶骨成形术。为使骨水泥能以与骨折纵向成一定角度注入，球囊导管经骶骨空心针从尾侧向头侧或从颅背侧向尾腹侧插入。然后用聚甲基丙烯酸甲酯（PMMA）骨水泥填充所形成的腔隙。接着进行对照CT检查及两个平面的传统X线检查。通过视觉模拟评分法（VAS）在干预前、干预后第2天以及干预后6个月和12个月确定疼痛强度。
球囊骶骨成形术在每位患者中技术操作良好。骶骨的对照CT和X线检查显示骨水泥分布充分，未检测到骨水泥渗漏。手术前，平均疼痛程度根据VAS评分为8.3。术后第2天，疼痛明显减轻，平均为2.7，6个月和12个月后平均为2.5，保持稳定。
球囊骶骨成形术是骶骨疲劳性骨折患者快速缓解疼痛的有效治疗方法。
