What Is Sacral Fracture Repair (Sacroplasty)?

Sacroplasty is a minimally invasive procedure used to treat painful sacral insufficiency fractures. The sacrum is the triangular bone at the base of the spine that connects to the pelvis.

These fractures most often occur because of osteoporosis (weakened bones) and can cause severe lower back, buttock, or pelvic pain that makes walking and daily activities difficult.

During sacroplasty, doctors inject medical-grade bone cement into the fractured areas of the sacrum to stabilize the bone, reduce pain, and help patients regain mobility. It works on the same principle as vertebroplasty or kyphoplasty performed in the spine.

Why Might I Need This Procedure?

Your doctor may recommend sacroplasty if you have:

• A painful sacral insufficiency fracture confirmed on imaging (MRI, CT, or bone scan)
• Pain that has not improved adequately with conservative treatment such as rest, pain medication, or bracing
• Difficulty walking or performing daily activities because of the fracture pain
• A fracture related to osteoporosis or, less commonly, cancer or other bone-weakening conditions

Sacroplasty is typically considered after conservative care has been tried and the pain remains disabling.

How Do I Prepare for the Procedure?

Your care team will give specific instructions. Typical preparation includes:

• Imaging: MRI, CT, or other studies to confirm the fracture is recent/unhealed and to plan the approach.
• Medications: You will usually stop blood-thinning medications for several days beforehand (only as directed by your physician). Tell your doctor about all medicines and supplements.
• Fasting: Do not eat or drink for several hours before the procedure (follow exact instructions).
• Transportation: Arrange for someone to drive you home. You will not be allowed to drive after sedation.
• Lab work: Blood tests may be needed to check clotting and overall health.

How Is the Procedure Performed

The procedure is typically done as an outpatient treatment under local anesthesia with moderate sedation (or sometimes general anesthesia). You will lie face-down. Imaging guidance (fluoroscopy or CT) is used throughout.

Typical steps:

1. The skin is cleaned and numbed. Using imaging guidance, a thin access needle/cannula is carefully advanced into the fractured sacrum.
2. A specialized instrument such as the PowerCURVE® Navigating Osteotome (part of the StabiliT MX system) may be used to create a small cavity or preferential pathway within the fracture zone while helping preserve surrounding bone.
3. Ultra-high viscosity StabiliT® bone cement is then delivered in a controlled manner into the prepared spaces. The high viscosity and controlled delivery are designed to help the cement stay within the desired area and interdigitate with the bone
4. The cement hardens within minutes, forming an internal support that stabilizes the fracture.
5. The instruments are removed, and a small bandage is applied. No stitches are usually needed.

What Should I Do for Aftercare?

Most patients go home the same day after a short observation period.

Immediate Recovery

• Rest for the first several hours; many centers recommend bed rest for 1–4 hours after the procedure.
• You may get up to use the bathroom once cleared.
• Mild soreness at the puncture sites is common; ice packs can help.

Activity Guidelines

• Gradually increase light activity and walking as tolerated.
• Avoid heavy lifting, repetitive bending, and strenuous activity for several weeks (typically 4–6 weeks or as directed).
• Many patients notice significant pain relief within the first 24–48 hours.

Wound Care & Follow-up

• Keep the bandage clean and dry for 24–48 hours.
• You may usually shower after 24–48 hours; avoid baths or soaking until the sites are healed.
• Follow up with your physician as scheduled. Continue osteoporosis treatment if recommended.

What Are the Risks?

Sacroplasty is generally considered safe when performed by experienced physicians. Possible risks include:

• Infection or bleeding at the puncture site
• Cement leakage (the high-viscosity cement and controlled technique are intended to help reduce this risk)
• Temporary increase in pain or, rarely, nerve irritation
• Allergic reaction to medications or cement components

Your physician will discuss the specific risks and benefits with you.

When Should I Call My Doctor?

Contact your healthcare provider promptly if you have:

• Increasing redness, swelling, warmth, or drainage from the puncture sites
• Fever of 100.4°F (38°C) or higher
• Severe or worsening pain not controlled by medication
• New numbness, tingling, or weakness in the legs
• Difficulty controlling bowel or bladder function