Sacroplasty

Sacral insufficiency fractures — most often from osteoporosis — are a distinct fracture from a vertebral compression fracture, occurring in the sacrum at the base of the spine rather than in a vertebral body. Under fluoroscopic or CT guidance, a needle is directed into the fractured portion of the sacrum, and bone cement is injected to stabilize it.

The sacrum's anatomy — irregular, curved, and close to nerve roots exiting toward the legs — makes precise, careful needle placement especially important here, distinct from the more straightforward vertebral body access used in kyphoplasty.

Stabilizing the fracture with cement eliminates the abnormal micromotion at the fracture site that drives much of the pain — the same underlying principle as kyphoplasty, applied to the sacrum's distinct anatomy rather than a vertebral body. Unlike kyphoplasty, sacroplasty doesn't involve restoring height with a balloon or implant first, since sacral insufficiency fractures don't collapse the same way a vertebral body does.

A growing base of supportive evidence documents meaningful pain relief for appropriately selected patients with sacral insufficiency fractures, applying the same cement-augmentation principle established for vertebral fractures to this anatomically distinct area.