sacral insufficiency fractures
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2021 ◽  
Vol 27 (3) ◽  
pp. 183-186
Author(s):  
Esra Cansu Selbes ◽  
Ezgi Yıldız Güvercin ◽  
Ece Çınar ◽  
Simin Hepgüler ◽  
İpek Tamsel

2021 ◽  
Vol 2 (22) ◽  
Author(s):  
David C. Kieser ◽  
Scheherezade Soltani ◽  
Niels Hammer ◽  
Amir Koutp ◽  
Eleanor Hughes ◽  
...  

BACKGROUND Sacrectomy carries significant risk of bleeding; however, specific risk factors, apart from medical comorbidities and tumor type, for this life-threatening complication remain unclear. This study describes two cases of massive bleeding, including one death during sacrectomy attributable to adherence of the internal iliac vein (IIV) and its neuroforaminal tributaries from sacral insufficiency fractures. OBSERVATIONS The authors presented two cases involving patients who received sacrectomy for a chordoma and experienced massive bleeding from the IIV due to adherence of the IIV and its neuroforaminal tributaries around sacral insufficiency fractures. They assessed their institution’s previous two decades’ experience of sacrectomies to determine risk factors for massive bleeding and performed anatomical dissection of 20 hemipelvises, which revealed the close proximity of the IIV to the sacral foraminae and the consistency of neuroforaminal tributaries arising from the foraminae. LESSONS Sacral insufficiency fractures may cause scarring that adheres to the IIV and its neuroforaminal tributaries, which risks massive bleeding during sacrectomy.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Isabel Graul ◽  
Patrick Strube ◽  
Sophia Vogt ◽  
Georg Matziolis ◽  
Steffen Brodt ◽  
...  

Author(s):  
Ulrich Josef Albert Spiegl ◽  
Klaus J. Schnake ◽  
Bernhard Ullrich ◽  
Max J. Scheyerer ◽  
Georg Osterhoff ◽  
...  

AbstractAn increasing incidence of sacral insufficiency fractures in geriatric patients has been documented, representing a major challenge to our healthcare system. Determining the accurate diagnosis requires the use of sectional imaging, including computed tomography and magnetic resonance imaging. Initially, non-surgical treatment is indicated for the majority of patients. If non-surgical treatment fails, several minimally invasive therapeutic strategies can be used, which have shown promising results in small case series. These approaches are sacroplasty, percutaneous iliosacral screw fixation (S1 with or without S2), trans-sacral screw fixation or implantation of a trans-sacral bar, transiliac internal fixator stabilisation, and spinopelvic stabilisation. These surgical strategies and their indications are reported in detail. Generally, treatment-related decision making depends on the clinical presentation, fracture morphology, and attending surgeonʼs experience.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Marla A. Petriello ◽  
Suzanne Groah ◽  
Suman D. Matiana

Abstract Introduction Osteoporosis is a common secondary complication of spinal cord injury, with fragility fractures typically occurring in the lower body and management often is conservative. Case presentation We present a 52-year-old male with chronic complete tetraplegia who presented to the emergency room with unremitting autonomic dysreflexia (AD). He was admitted for medical management of the AD when a source of the AD could not be identified. After an extensive workup, the patient was found to have bilateral sacral insufficiency fractures. He subsequently underwent sacroplasty with immediate and full resolution of AD symptoms and return to full premorbid function within 24 h. Discussion People with chronic spinal cord injury (SCI) are at risk for spinal column fragility fractures in addition to lower extremity fractures. Vertebroplasty may be a safe option for treatment of insufficiency fractures in situations where conservative care may put people at risk for significant immobility-associated complications.


2021 ◽  
Author(s):  
Rahul Hegde, MBBS, MD, DNB, FRCR ◽  
Ayah A. Megahed, MBBCh ◽  
Noel B. Velasco, MD

2020 ◽  
pp. 028418512096856
Author(s):  
Hasan Emin Kaya ◽  
Ülkü Kerimoğlu

Background In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient’s symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.


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