ArticleBMC musculoskeletal disorders2025
Early experience with percutaneous photodynamic nails for sacral metastatic disease and insufficiency fractures: a retrospective cohort analysis of functionality and pain relief.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Percutaneous fixation of posterior pelvic ring lesions in the elderly: current evidence and recent advances.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
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8 authors.
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Abstract
backgroundTreatment of impending pathologic fractures and insufficiency fractures of the sacrum due to metastatic disease and radiation is challenging. The use of traditional hardware is limited by poor bone quality and presence of non-contained defects. The role of minimally invasive photodynamic nails (PDN) for treatment of these fractures remains poorly understood.
methodsPatients with symptomatic impending pathologic fractures of the sacrum due to metastatic bone disease, multiple myeloma, or insufficiency fractures from radiation osteitis who underwent PDN stabilization were identified. Primary outcomes included post-operative complications, pain relief, opioid consumption, and function. Pain was assessed using Visual Analog Scale (VAS), and function was measured using the Combined Pain and Ambulatory Function (CPAF) score. Outcomes were assessed preoperatively at 6 weeks, 3 months, 6 months, 1 year and 2 years.
resultsFourteen patients (median age 70, 50% female) underwent sacral PDN stabilization between 2020 and 2023, with a median 1.4-year follow-up. Overall complication rate was 7% (1/14 patients), with one case of venous thromboembolism. Median pain VAS decreased from 7 preoperatively to 6 at 6 weeks (p = 0.02), and to 4 at 2 years (p = 0.002). Median CPAF score improved from 6 preoperatively to 7 at 3 months and remained at this level through the 2-year follow-up. Chronic opioid use decreased from 85.7% preoperatively to 60% at 2 years.
conclusionPDN stabilization sacral insufficiency fractures in oncologic patients is a safe surgical technique that effectively restores patient ambulatory function and provides rapid pain relief. Further research with larger cohorts is warranted to confirm these promising results. LEVEL OF EVIDENCE: III. CLINICAL TRIAL NUMBER: Not applicable.
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