Sacral Augmentation: Comprehensive Review

Sacral insufficiency fractures (SIF) require prompt intervention, as they are associated with high morbidity and worsened quality of life. Standard of care currently involves a multimodal approach of rehabilitation and pharmacological therapies. However, these measures may not provide significant pain relief and pose additional risks relating to prolonged immobility and analgesic dependence. Sacroplasty is a minimally invasive imaging-guided alternative to conservative management in the treatment of SIF. This procedure involves the injection of polymethyl methacrylate (PMMA) cement under guidance of computed tomography and/or fluoroscopy to reinforce the stability and durability of SIF. Sacroplasty is associated with rapid pain relief, improvement of functional status, and decreased analgesic use. Complications, most commonly cement extravasation, are few and generally clinically insignificant.