{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:43:09Z","timestamp":1782978189766,"version":"3.54.5"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Geriatr Orthop Surg Rehabil"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Examine the feasibility, safety, and results of a novel sacral percutaneous injection technique (\u201cXX\u201d) addressing both the vertical and horizontal aspects of sacral insufficiency fractures (SIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective cohort study. Eight consecutive SIF patients with immobility and pain investigated using CT and nuclear imaging confirmed \u201cH\"-type fracture. Demographics, pain level, and ambulation status were recorded. The long-term quality of life was evaluated using the ODI questionnaire and pain VAS scores. Sacroplasty procedures in prone positioning using fluoroscopy were used to insert 2 bone trochars through the S1 pedicles and 2 trochars through the sacral ale aiming toward the SIJ, thus forming 2 \u201cX\u201d trochar formations. Balloon kyphoplasty was done through the trocars, and PMM was injected. Postoperative ambulation and VAS were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Average age was 81.5 years (\u00b13.4\u00a0years). The time from presenting symptoms to hospital admission was 2\u00a0days to 4\u00a0months. All patients were significantly limited with ambulation. None had a neurologic compromise. Sacroplasty was performed with 2 cases that required additional lumbar kyphoplasty. The mean operative time was 54\u00a0min (\u00b114). The average exposure was 19\u00a0mGy (\u00b112\u00a0mGy). Two patients had cement leaks. CT and X-rays revealed good cement filling of the fractures sacral alae and body of S1. The average postoperative hospitalization was 10\u00a0days. All patients reported postoperatively pain relief immediately and were able to walk better. Follow-up time was 17 \u00b1 12\u00a0months. Follow-up VAS was 2.7 (\u00b12) and ODI was 57.3% (\u00b121%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\u201cXX\u201d technique showed good outcomes for patients with higher complexity SIF, using the same principles as for lumbar VPL\/KPL, and was found to be safe and effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21514593211049671","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T11:00:26Z","timestamp":1643972426000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["\u2018XX\u2019\u2013Sacroplasty: A Novel Technique for Management of \u201cH-Type\u201d Sacral Insufficiency Fractures"],"prefix":"10.1177","volume":"13","author":[{"given":"Raphael","family":"Lotan","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel"},{"name":"Sackler Faculty of Medicine, Tel. 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