E-018 percutaneous sacroplasty for the management of painful pathologic fracture in a multiple myeloma patient
Bibliographic record
Abstract
<h3>Introduction</h3> Percutaenous vertebroplasty has a well-established role in the treatment of pathologic fractures in patients with multiple myeloma. Despite this, there is a scarcity of literature surrounding its use and efficacy in the sacrum. We present a case of successful symptom resolution in a patient with painful sacral fracture following sacroplasty. Case presentation An 81 year-man with multiple myeloma presented to the hematology/oncology clinic with a history of excruciating pain while seated. The impact of this pain on his quality of life subjectively was rated to be particularly high. Plain radiographs of the sacrum confirmed the presence of pathologic fracture within the body of S2, later characterized with computed tomography. Under fluoroscopic guidance, polymethyl methacrylate (PMMA) bone cement was injected via an 18 gage needle using a far-lateral approach. No immediate post-procedural complications occurred, such as foraminal extravasation and venous injection. The patient reported himself to be pain-free one day following the procedure and this remains the case to-date at two years of follow-up. <h3>Discussion</h3> Sacroplasty is technically feasible and can provide durable relief of symptoms in patients with both painful pathologic fractures of the sacrum. It is likely underused and can offer tremendous benefit to myeloma patients. Analgesia intolerance and functional obstacles to quality of life (e.g., sitting up) should be common clinical considerations. Important technical considerations include cement volume delivered and the potential for complications. <h3>Disclosures</h3> A. Dmytriw: None. R. Smith: None.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".