Sacral kyphoplasty for relieving pain caused by sacral hemangioma

Abstract

Study design: Case report describing sacral kyphoplasty in a patient with sacral hemangioma; the first account of this procedure in a sacral hemangioma. Objectives: To highlight the advantages of sacral kyphoplasty in the treatment of sacral tumors. Setting: This study is made in Baskent University in Turkey. Summary of background data: Kyphoplasty and sacroplasty are new, minimally invasive techniques that are mostly used for treating osteoporotic vertebral body fractures. These techniques are very effective for achieving rapid pain relief and stabilizing the vertebra, and biopsy collection can be included in the procedure. The latter allows for informed treatment planning in patients with metastatic tumors. Method: A 74-year-old woman with known metastatic renal cell carcinoma was investigated for pain in the left sacral region. A tumoral lesion was detected, and sacroplasty was performed at S1. Results: The sacral pain resolved completely after the procedure, and the patient was able to walk without assistance. The pathological diagnosis for the vertebral lesion was hemangioma. Conclusions: Sacral kyphoplasty is a very effective, minimally invasive surgical procedure. Patients with debilitating diseases such as primary sacral tumors or metastases can be treated by this technique with no significant complications.

Balloon Sacroplasty as a Palliative Pain Treatment in Patients with Metastasis-Induced Bone Destruction and Pathological Fractures

“…In our own patients as well as the sacrokyphoplasty cases published to date, no leakage was seen in the post-operative imaging even though the degree of bone destruction varied considerably [8,9,21], which in our view is a great advantage of the balloon technique. Cement augmentation using a vesselplasty balloon can possibly be guided even more accurately in tumor tissue with a pronounced soft tissue component and destruction-related loss of bony landmarks, which can reduce the risk of leakages even further [24].…”

“…main reason for the pain reduction experienced immediately after the intervention, while the thermal effect caused by cement hardening also plays a role [11,20]. Cement augmentation analogous to kyphoplasty is less well known at present, but shows comparably good results with regard to pain reduction [8,9,21]. Using a balloon catheter, a central cavity is created in the lesion for the introduction of the cement, whereby a compaction of peripheral tumor tissue and the adjacent pathological fracture zone closes possible fissures [8], and thus makes it more difficult for cement to leak in the direction of the neuroforamina, iliosacral joints and visceral surface of the sacrum.…”

First Experience Using Navigation-Guided Radiofrequency Kyphoplasty for Sacroplasty in Sacral Insufficiency Fractures

“…Conventional balloon kyphoplasty has been described for osteoporotic fractures [11,20,31], metastatic fractures [20], and a sacral hemangioma [32] Abb. 7 Postoperative Bildgebung (Patient 1).…”

Imaging and Treatment of Sacral Insufficiency Fractures

“…5,8 In addition to osteoporotic fractures, sacroplasty has been used to treat painful metastatic lesions in the sacrum. 43,44 Case reports describe sacral cement injection for hepatocellular carcinoma, 52 hemangioma, 53 lung cancer and lymphoma, 54 and renal cell carcinoma and myeloma. 55 Complications of sacroplasty involve the unexpected extrusion of PMMA cement outside of the fractured sacrum, with untoward neurologic sequelae being the highest concern.…”