Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
Skeletal Radiol. 2024 Jan;53(1):93-98. doi: 10.1007/s00256-023-04386-5. Epub 2023 Jun 10.
Percutaneous sacroplasty is a minimally invasive procedure which utilises injection of bone cement into the sacrum for stabilisation of osteoporotic sacral insufficiency fractures (SIF) and neoplastic lesions to relieve pain and improve function. While effective, cement leakage is an important complication associated with the procedure. This study aims to compare the incidence and patterns of the cement leakages following sacroplasty for SIF versus neoplasia and discuss the various patterns of cement leakage and their implications.
This retrospective study analysed 57 patients who underwent percutaneous sacroplasty at a tertiary orthopaedic hospital. Patients were divided into 2 groups of SIF (n=46) and neoplastic lesions (n=11) based on their indication for sacroplasty. Pre- and post-procedural CT fluoroscopy was used to assess for cement leakage. The incidence and patterns of cement leakage were both compared among the two groups. A Fisher's exact test was used for statistical analysis.
Eleven (19%) patients had cement leakage on post-procedural imaging. The most common sites of cement leakage were into the presacral region (6), followed by sacroiliac joints (4), sacral foramina (3) and posterior sacral (1). There was a statistically significant higher incidence of leakage in the neoplastic group in comparison to SIF group (P-value <0.05). The incidence of cement leakage in the neoplastic group was 45% (n = 5/11) versus SIF 13% (n=6/46).
There was a statistically significant higher incidence of cement leak in sacroplasties conducted for the treatment of neoplastic lesions compared to those with sacral insufficiency fracture.
经皮骶骨成形术是一种微创技术，通过向骶骨内注射骨水泥来稳定骨质疏松性骶骨不稳定性骨折（SIF）和肿瘤病变，以缓解疼痛和改善功能。虽然有效，但水泥渗漏是该手术的一个重要并发症。本研究旨在比较 SIF 与肿瘤行骶骨成形术后水泥渗漏的发生率和类型，并讨论各种类型的水泥渗漏及其意义。
这项回顾性研究分析了在一家三级骨科医院行经皮骶骨成形术的 57 名患者。根据行骶骨成形术的适应证，患者分为 SIF 组（n=46）和肿瘤组（n=11）。术前行 CT 透视，术后行 CT 透视评估水泥渗漏。比较两组水泥渗漏的发生率和类型。采用 Fisher 确切概率法进行统计学分析。
11 名（19%）患者术后影像学检查发现水泥渗漏。最常见的水泥渗漏部位是骶前区（6 例），其次是骶髂关节（4 例）、骶骨孔（3 例）和骶骨后区（1 例）。与 SIF 组相比，肿瘤组的漏诊率有统计学意义（P 值<0.05）。肿瘤组水泥渗漏发生率为 45%（n=5/11），SIF 组为 13%（n=6/46）。
与治疗 SIF 的骶骨成形术相比，治疗肿瘤的骶骨成形术的水泥渗漏发生率有统计学意义。
