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BackTable / MSK / Podcast / Episode #51

Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures

with Dr. Douglas Beall

In this episode of the BackTable MSK Podcast, Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, and the need to increase awareness of sacral fractures and sacroplasty.

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Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures with Dr. Douglas Beall on the BackTable MSK Podcast)
Ep 51 Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures with Dr. Douglas Beall
00:00 / 01:04

BackTable, LLC (Producer). (2024, June 19). Ep. 51 – Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures [Audio podcast]. Retrieved from

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Podcast Contributors

Dr. Douglas Beall discusses Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures on the BackTable 51 Podcast

Dr. Douglas Beall

Dr. Douglas Beall is the Chief of Radiology Services at Clinical Radiology of Oklahoma.

Dr. Jacob Fleming discusses Sacroplasty I: Principles & New Data in the Treatment of Sacral Insufficiency Fractures on the BackTable 51 Podcast

Dr. Jacob Fleming

Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.


Dr. Beall emphasizes the underrecognition and undertreatment of sacral insufficiency fractures, pointing out the high mortality and chronic pain rates associated with non-treatment. He urges providers to consider this diagnosis, especially if the patient is describing symptoms of pain with position changes with standing, sitting, and laying, has pubic rami fractures, or reports a history of pelvic radiation. Even with imaging, the diagnosis can remain elusive, since it is not commonly recognized on x-ray and may not show obvious cortical disruption on CT or MRI.

We also review the current literature on sacroplasty efficacy in lowering patient-reported pain scores and adverse events associated with treatment versus conservative management. Dr. Beall speaks about the importance of real-world data collection in the form of patient registries and the insight that these resulting studies have on applications of sacroplasty in specific patient populations.


00:00 - Introduction
03:01 - Sacral Fractures and Sacroplasty
15:17 - Treatment Options for Sacral Fractures
17:34 - Consequences of Untreated Sacral Fractures
28:32 - Sacroplasty Registry and Current Research
38:08 - Imaging Modalities: CT vs. Fluoroscopy
40:49 - Complications of Sacroplasty: Extravasation
43:21 - Bone Quality and Fracture Healing
45:42 - Growing Awareness of Sacral Fractures and Treatment Options


Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly (Lourie, 1982):

Percutaneous cementoplasty for pelvic bone metastasis (Marcy, 2000):

Safety and Efficacy of Sacroplasty for Sacral Fractures: A Systematic Review and Meta-Analysis (Chandra et al, 2019):

Percutaneous sacroplasty for osteoporotic sacral insufficiency fractures: a prospective, multicenter, observational pilot study (Frey et al, 2008):

Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations (Frey et al, 2017):

Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation (Beall, 2020):

An Interim Analysis of the First 102 Patients Treated in the Prospective Vertebral Augmentation Sacroplasty Fracture Registry (Beall et al, 2023):

Clinical Effect of Balloon Kyphoplasty in Elderly Patients with Multiple Osteoporotic Vertebral Fracture (Liu et al, 2019):

The presenter may have or have had a financial or advisory relationship with Stryker.

The information presented is intended solely for educational purposes for healthcare professionals. The treatment regimen(s), technique(s) and protocol(s) described by the presenter reflect his or her professional clinical judgment and opinion(s). Stryker does not recommend any specific treatment regimen, technique or protocol to be used when using our devices and a healthcare professional must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that healthcare professionals be trained in the use of any particular product before using the product.

Stryker does not assume any responsibility for coding decisions, nor does it recommend codes for specific patients’ procedures. The provider is solely responsible for reporting the codes that accurately describe the services furnished to a particular patient as well as the patient’s medical condition. It is the provider’s responsibility to determine and document that the services provided are medically necessary and that the site of service is appropriate. It is the health care provider’s responsibility to report the patient diagnosis, the procedures performed and the products used, consistent with the specific payer’s guidelines.

Stryker or its affiliated entities own, use, or have applied for the following trademarks or service marks: Stryker. All other trademarks are trademarks of their respective owners or holders. The absence of a product, feature, or service name, or logo from this list does not constitute a waiver of Stryker’s trademark or other intellectual property rights concerning that name or logo.

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Back Pain Condition Overview
Chronic Pain Condition Overview
Kyphoplasty Procedure Prep
Low Back Pain Condition Overview
Osteoporosis Condition Overview
Pain Management Procedure Prep

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