Tian QH, Liu HF, Wang T, et al. - Given a wide use of percutaneous sacroplasty (PSP) in the clinic for osteoporotic sacral insufficiency fractures, researchers here examined the safety and efficacy of fluoroscopy-guided PSP for painful metastases at the sacral ala. Treatment with PSP was provided to 35 consecutive patients (median age, 60.74 ± 12.74 years), with a total of 41 metastatic lesions at the sacral ala. They achieved technical success in all patients. Outcomes support the safety and efficacy of PSP as the palliative treatment of painful metastases involving the sacral ala under fluoroscopic guidance alone. It led to the achievement of pain relief, disability reduction, and function improvement with minimal complications.