Background: Insufficiency fractures at the sacrum represent a considerable cause of low back pain and disability within the geriatric population. However, there has never been a large-scale study examining the epidemiologic trends associated with the disease, and thus this condition has been largely under recognized.

Methods: This study analyzed a Nationwide Inpatient Sample (NIS) database to trend frequency and burden of sacral insufficiency fractures (SIF). All inpatient stays from 1998 to 2010 noted on the NIS were included if the case maintained at least one or more diagnostic code. A total of 257,697 unique admissions (63% women, 37% men) met our criteria.

Results: In 1998, there were 14,629 occurrences of SIF in the NIS population; this number steadily increased to 35,434 by 2010. This is a 142% increase in SIF frequency in a 12-year span. Congruently, there was an exponential increase in the total financial burden of SIF on the NIS healthcare institutions. In 1998, the total financial burden of SIF within the NIS database was $581 million; this number increased to $3.18 billion in 2010, which represents a 514% increase.

Conclusions: Overall, the frequency of SIF may be increasing as our population ages. Limited understanding of the disease characteristics has created a disproportionate burden on the healthcare system.

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