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Sacral Insufficiency Fractures: a Review of Risk Factors, Clinical Presentation, and Management.
Current Pain and Headache Reports ( IF 3.2 ) Pub Date : 2020-02-17 , DOI: 10.1007/s11916-020-0848-z
Ivan Urits 1 , Vwaire Orhurhu 1 , Jessica Callan 2 , Nishita V Maganty 2 , Sara Pousti 2 , Thomas Simopoulos 1 , Cyrus Yazdi 1 , Rachel J Kaye 3 , Lauren K Eng 4 , Alan D Kaye 3 , Laxmaiah Manchikanti 5 , Omar Viswanath 6, 7, 8
Affiliation  

Purpose of the Review

Sacral insufficiency fractures (SIF) are a common and often underdiagnosed source of low back pain. In patients with SIF, there is both a compromised sacroiliac joint and weakened sacrum, resulting in decreased resistance to torsional stress, leading to fracture. While conservative medical management is a safe option, minimally invasive intervention may provide improved short and long-term relief of low back pain in patients presenting with SIF. This comprehensive review is undertaken to provide an update to the current understanding of SIF with description of risk factors, clinical presentation, and management.

Recent Findings

Sacroplasty is a minimally invasive procedure in which polymethylmethacrylate (PMMA) cement is inserted into bone to improve its structural integrity and alleviate symptoms. Balloon sacroplasty (BSP) has also been successful in alleviating pain with minimal cement leakage in SIF patients. Various other interventional techniques, including navigation-assisted screw fixation have been used to address SIF and have shown improvement in pain with minimal side effects.

Summary

This review included various modalities of treatments available to manage SIF. This review shows that in comparison with nonsurgical management, sacroplasty has been shown to have greater pain reduction and improved mobility.


中文翻译:

ac骨功能不全骨折:危险因素,临床表现和管理的审查。

审查目的

骨功能不全骨折(SIF)是下腰痛的常见且经常被误诊的原因。在SIF患者中,sa关节受损且骨减弱,导致对扭转应力的抵抗力降低,从而导致骨折。尽管保守的医疗管理是一种安全的选择,但微创干预可以改善SIF患者的腰背疼痛的短期和长期缓解。进行这项全面的审查是为了对当前对SIF的理解进行更新,包括对危险因素,临床表现和管理的描述。

最近的发现

cro囊成形术是一种微创手术,其中将聚甲基丙烯酸甲酯(PMMA)水泥插入骨中以改善其结构完整性并减轻症状。球囊sa囊成形术(BSP)也已成功减轻SIF患者的疼痛,并使水泥渗漏降至最低。包括导航辅助螺钉固定在内的各种其他介入技术已被用于解决SIF,并且显示出疼痛的改善以及最小的副作用。

概要

该评价包括可用于治疗SIF的各种治疗方式。该评价表明,与非手术治疗相比,sa囊成形术具有更大的减轻疼痛感和改善的活动性。
更新日期:2020-02-17
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