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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1494377

Sacroplasty with or without Screw Fixation for Sacral Metastatic Tumors

Provisionally accepted
Evan Cox Evan Cox 1*Sean Tutton Sean Tutton 2Matthew Scheidt Matthew Scheidt 1Brandon Key Brandon Key 1John C Neilson John C Neilson 1Adam Wooldridge Adam Wooldridge 1Manpreet (Meena) Bedi Manpreet (Meena) Bedi 1Don Hackbarth Don Hackbarth 1David M King David M King 1
  • 1 Medical College of Wisconsin, Milwaukee, United States
  • 2 UC San Diego Health, University of California, San Diego, San Diego, California, United States

The final, formatted version of the article will be published soon.

    Introduction: Cementation (sacroplasty) with or without ablation has been shown to improve pain and function for patients with sacral metastatic disease. Percutaneous screw fixation with sacroplasty (PSFS) may provide superior outcomes in select patients. Methods: Thirty patients with sacral metastases who underwent sacroplasty with or without ablation and screw fixation at a single institution were retrospectively reviewed. Patients were compared based on treatment (PSFS or sacroplasty alone) and fracture status (pathological or impending) with an ANCOVA. Traumatic fractures were excluded. Patients were followed for 4.4 months on average (range, 2 weeks to 36.5 months). Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) score. The rate of secondary procedures as well as changes in narcotic usage were noted. Results: Patients with pathological fractures who underwent PSFS demonstrated increased postoperative MSTS scores compared to those who underwent sacroplasty (51%  19 versus 25%  13, p = 0.005). Patients with impending pathological fractures who underwent PSFS did not demonstrate statistically significant increased postoperative MSTS scores compared to those who underwent sacroplasty alone (38%  17 versus 32%  12, p = 0.72). Discussion: PSFS may provide additional benefit for patients with pathological fractures, while sacroplasty alone may be sufficient for those with impending pathologic fractures secondary to sacral metastatic disease. This study was limited by its retrospective design and sample size; however, the results may aid in treatment indications for sacral metastases and guide further research Level of Evidence Level III, Therapeutic Study.

    Keywords: Percutaneous screw fixation, Sacroplasty, Sacral metastases, pathological fracture, Impending fracture, Cementation, Screw augmentation

    Received: 10 Sep 2024; Accepted: 07 Feb 2025.

    Copyright: © 2025 Cox, Tutton, Scheidt, Key, Neilson, Wooldridge, Bedi, Hackbarth and King. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Evan Cox, Medical College of Wisconsin, Milwaukee, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.