Percutaneous Sacroplasty for Symptomatic Sacral Pedicle Screw Loosening

Background This study aimed to evaluate the efficacy of fluoroscopy-guided percutaneous sacroplasty in patients with sacral pedicle screws loosening after instrumented spinal fusion. Methods We retrospectively reviewed the medical records of 18 patients who underwent percutaneous sacroplasty to treat sacral pedicle screws loosening from January 2016 to December 2019. Imaging studies, visual analog scale (VAS), length of hospital stay, and complications were recorded. The clinical outcomes based on the Oswestry disability index (ODI) and the modified Brodsky’s criteria (MBC) were also evaluated to determine the efficacy of percutaneous sacroplasty. Results All patients had undergone at least 1 year of follow-up in our institute (range, 12–24 months). The average VAS score was 5.6 (range, 4–7) before surgery and decreased to 1.7 (range, 1–3) at the final visit. All patients were discharged on the next day after surgery. No patients experienced complications, such as cement leakage, deep infection, or neurologic deterioration. All patients achieved good or excellent outcomes based on the MBC. The ODI scores improved from 51.8 preoperatively to 25.6 postoperatively. Conclusion Percutaneous sacroplasty was an effective treatment approach for relieving the patient’s symptoms caused by sacral pedicle screws loosening and could be a valuable treatment alternative to extensive revision surgery. Level of clinical evidence IV