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<meta name="DC.Title" content="Investigating Sacroplasty: Technical Considerations and Finite Element Analysis of Polymethylmethacrylate Infusion into Cadaveric Sacrum" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0500" />
<meta name="DC.Date" content="2007-06-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Sacroplasty is not as routinely performed as vertebroplasty, possibly due to technical challenges and the paucity of data regarding subsequent outcomes. The first goal of the present investigation was to describe a technique for sacroplasty that facilitates safe needle placement and polymethylmethacrylate (PMMA) extrusion. The second goal was to perform finite element analysis (FEA) by using a geometric model of sacral fracture to identify mechanical outcomes of sacroplasty.

MATERIALS AND METHODS: Sacroplasty was performed on fresh pelvis specimens ( n = 4) under biplane fluoroscopy. Cadavers were imaged via CT before and after sacroplasty and volume rendered to examine needle placement and PMMA extrusion. The volume-rendered CT data were then used to generate geometric models of the intact, fractured, and cement-augmented fractured sacrum for comparison by using FEA.

RESULTS: CT data demonstrate that safe injection needle placement and PMMA delivery may be facilitated by orienting the needle parallel to the L5-S1 interspace and ipsilateral sacroiliac joint, then targeting the superolateral sacral ala within an area bounded by a line lateral to the posterior foraminal openings and a line superimposed on the medial edge of the sacroiliac joint. FEA revealed that simulated sacroplasty decreased maximal principal stress at the point of sacral fracture propagation by 83% and fracture gap micromotion by 48%.

CONCLUSION: Sacral landmarks can be used to place PMMA safely where sacral fractures occur. FEA suggests that sacroplasty may decrease fracture-associated mechanical stress and micromotion, which may contribute to patient reports of decreased pain and increased mobility postsacroplasty." />
<meta name="DC.Contributor" content="C.T. Whitlow" />
<meta name="DC.Contributor" content="S.K. Yazdani" />
<meta name="DC.Contributor" content="M.L. Reedy" />
<meta name="DC.Contributor" content="S.E. Kaminsky" />
<meta name="DC.Contributor" content="J.L. Berry" />
<meta name="DC.Contributor" content="P.P. Morris" />
<meta name="article:published_time" content="2007-06-01" />
<meta name="article:section" content="SPINE" />
<meta name="citation_title" content="Investigating Sacroplasty: Technical Considerations and Finite Element Analysis of Polymethylmethacrylate Infusion into Cadaveric Sacrum" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Sacroplasty is not as routinely performed as vertebroplasty, possibly due to technical challenges and the paucity of data regarding subsequent outcomes. The first goal of the present investigation was to describe a technique for sacroplasty that facilitates safe needle placement and polymethylmethacrylate (PMMA) extrusion. The second goal was to perform finite element analysis (FEA) by using a geometric model of sacral fracture to identify mechanical outcomes of sacroplasty.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; Sacroplasty was performed on fresh pelvis specimens (&lt;i&gt;n&lt;/i&gt; = 4) under biplane fluoroscopy. Cadavers were imaged via CT before and after sacroplasty and volume rendered to examine needle placement and PMMA extrusion. The volume-rendered CT data were then used to generate geometric models of the intact, fractured, and cement-augmented fractured sacrum for comparison by using FEA.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; CT data demonstrate that safe injection needle placement and PMMA delivery may be facilitated by orienting the needle parallel to the L5-S1 interspace and ipsilateral sacroiliac joint, then targeting the superolateral sacral ala within an area bounded by a line lateral to the posterior foraminal openings and a line superimposed on the medial edge of the sacroiliac joint. FEA revealed that simulated sacroplasty decreased maximal principal stress at the point of sacral fracture propagation by 83% and fracture gap micromotion by 48%.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION:&lt;/b&gt; Sacral landmarks can be used to place PMMA safely where sacral fractures occur. FEA suggests that sacroplasty may decrease fracture-associated mechanical stress and micromotion, which may contribute to patient reports of decreased pain and increased mobility postsacroplasty.&lt;/p&gt;" />
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<meta name="citation_publication_date" content="2007/06/01" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Sacroplasty is not as routinely performed as vertebroplasty, possibly due to technical challenges and the paucity of data regarding subsequent outcomes. The first goal of the present investigation was to describe a technique for sacroplasty that facilitates safe needle placement and polymethylmethacrylate (PMMA) extrusion. The second goal was to perform finite element analysis (FEA) by using a geometric model of sacral fracture to identify mechanical outcomes of sacroplasty.

MATERIALS AND METHODS: Sacroplasty was performed on fresh pelvis specimens ( n = 4) under biplane fluoroscopy. Cadavers were imaged via CT before and after sacroplasty and volume rendered to examine needle placement and PMMA extrusion. The volume-rendered CT data were then used to generate geometric models of the intact, fractured, and cement-augmented fractured sacrum for comparison by using FEA.

RESULTS: CT data demonstrate that safe injection needle placement and PMMA delivery may be facilitated by orienting the needle parallel to the L5-S1 interspace and ipsilateral sacroiliac joint, then targeting the superolateral sacral ala within an area bounded by a line lateral to the posterior foraminal openings and a line superimposed on the medial edge of the sacroiliac joint. FEA revealed that simulated sacroplasty decreased maximal principal stress at the point of sacral fracture propagation by 83% and fracture gap micromotion by 48%.

CONCLUSION: Sacral landmarks can be used to place PMMA safely where sacral fractures occur. FEA suggests that sacroplasty may decrease fracture-associated mechanical stress and micromotion, which may contribute to patient reports of decreased pain and increased mobility postsacroplasty." />
<meta name="og-title" property="og:title" content="Investigating Sacroplasty: Technical Considerations and Finite Element Analysis of Polymethylmethacrylate Infusion into Cadaveric Sacrum" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Sacroplasty is not as routinely performed as vertebroplasty, possibly due to technical challenges and the paucity of data regarding subsequent outcomes. The first goal of the present investigation was to describe a technique for sacroplasty that facilitates safe needle placement and polymethylmethacrylate (PMMA) extrusion. The second goal was to perform finite element analysis (FEA) by using a geometric model of sacral fracture to identify mechanical outcomes of sacroplasty.

MATERIALS AND METHODS: Sacroplasty was performed on fresh pelvis specimens ( n = 4) under biplane fluoroscopy. Cadavers were imaged via CT before and after sacroplasty and volume rendered to examine needle placement and PMMA extrusion. The volume-rendered CT data were then used to generate geometric models of the intact, fractured, and cement-augmented fractured sacrum for comparison by using FEA.

RESULTS: CT data demonstrate that safe injection needle placement and PMMA delivery may be facilitated by orienting the needle parallel to the L5-S1 interspace and ipsilateral sacroiliac joint, then targeting the superolateral sacral ala within an area bounded by a line lateral to the posterior foraminal openings and a line superimposed on the medial edge of the sacroiliac joint. FEA revealed that simulated sacroplasty decreased maximal principal stress at the point of sacral fracture propagation by 83% and fracture gap micromotion by 48%.

CONCLUSION: Sacral landmarks can be used to place PMMA safely where sacral fractures occur. FEA suggests that sacroplasty may decrease fracture-associated mechanical stress and micromotion, which may contribute to patient reports of decreased pain and increased mobility postsacroplasty." />
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      <h1 class="highwire-cite-title" id="page-title">Investigating Sacroplasty: Technical Considerations and Finite Element Analysis of Polymethylmethacrylate Infusion into Cadaveric Sacrum</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C.T. Whitlow</span>, <span class="highwire-citation-author" data-delta="1">S.K. Yazdani</span>, <span class="highwire-citation-author" data-delta="2">M.L. Reedy</span>, <span class="highwire-citation-author" data-delta="3">S.E. Kaminsky</span>, <span class="highwire-citation-author" data-delta="4">J.L. Berry</span> and <span class="highwire-citation-author" data-delta="5">P.P. Morris</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2007,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1036-1041; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0500 </span></div>
  
  
  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-28.6.1036.1" data-doi="10.1001/jama.1982.03330060055034"><div class="cit-metadata"><cite>Lourie H. <strong>Spontaneous osteoporotic fracture of the sacrum: an unrecognized syndrome of the elderly.</strong> <span class="cit-source">JAMA</span> <span class="cit-pub-date">1982</span>;<span class="cit-vol">248</span>:<span class="cit-fpage">715</span>–17</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.1982.03330060055034&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 28</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">June 2007 </div></div>
      
      
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      <div class="highwire-cite-title">Investigating Sacroplasty: Technical Considerations and Finite Element Analysis of Polymethylmethacrylate Infusion into Cadaveric Sacrum</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2007, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1036-1041; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0500 </span></div>
  
  
  
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