Disclosures: Radhika Sharma, MD: No financial relationships or conflicts of interest

Case Description: Sacroplasty has been shown to be a safe and effective way to treat sacral insufficiency fractures, however there is little evidence for the use of sacroplasty as an office-based procedure using oral sedatives and local anesthetics. The objective of this abstract is to demonstrate the clinical utility of office-based sacroplasty for the management of sacral insufficiency fractures. This case series describes two patients who presented to clinic with 4 weeks of low back pain. Both were diagnosed through MRI with sacral insufficiency fractures and underwent sacroplasty.

Setting: These are two case reports detailing the use of sacroplasty in an office-based setting in patients with sacral insufficiency fractures.

Patient: Patient 1 presented to clinic with 4 weeks of back pain. MRI imaging revealed a non-displaced fracture of the left inferior hemisacrum with surrounding bone marrow edema. She underwent SI joint injections and trigger point injections each which only offered one day of pain relief. Patient 2 presented to clinic with 4 weeks of back pain. MRI findings revealed bilateral sacral insufficiency fractures with bone marrow edema. She underwent SI joint injections that provided 1 week of pain relief. Trigger point injections only offered 1 day of pain relief. Assessment/

Results: Both patients reported 100% improvement in their pain post-procedure. They were followed up at 2 weeks, 4 weeks, 6 months, and 1 year. Patient 1 reported 80% pain relief during this time and Patient 2 maintained 100% pain relief.

Discussion: Before sacroplasty, patients with sacral insufficiency fractures were typically prescribed bedrest, which can cause complications such as muscle/bone loss, decubitus ulcers, or deconditioning. Pain relief, through sacroplasty, can promote early ambulation, improving the health and well-being of affected patients.

Conclusion: Both patients discussed had a significant amount of pain relief 1 year post-procedure. In-office sacroplasty is a potentially safe and efficacious procedure to treat sacral insufficiency fractures.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/office-based-sacroplasty-using-local-anesthetics-and-oral-sedation-a-case-series/