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Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare the efficacy of percutaneous long bone cementoplasty (PLBC) with and without embedding a cement-filled catheter in the medullary canal (ECFC) for painful long bone metastases with impending fracture.

Methods

A retrospective study was conducted in 36 consecutive patients undergoing PLBC and ECFC combination (n = 17, group A) or PLBC alone (n = 19, group B). All patients had a high risk of impending fracture in the long bone based on Mirels’ scoring system. Clinical effects were evaluated using both a pre- and a postoperative visual analogue scale (VAS) and Karnofsky performance scale (KPS).

Results

Overall pain relief rate with excellent (VAS 0–2) and good (VAS 2.5–4.5) results during follow-up was significantly higher in group A than in group B (88.2 % vs. 57.9 %, P<0.05). The average VAS and KPS changes in group A were significantly higher than those in group B at 1, 3 and 6 months postoperatively (P<0.05). Also, the rate of fractures of the treated long bone in group A was significantly lower than that in group B (P<0.05).

Conclusions

Combined PLBC and ECFC is a safe and effective procedure for long bone metastases with impending fracture.

Key Points

• Metastases in long bones may cause pain and subsequent pathological fractures.

• Cementoplasty resulted in significant pain relief in patients with long bone metastases.

• Combination of PLBC and ECFC may reduce the incidence of fractures.

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References

  1. Anselmetti GC (2010) Osteoplasty: percutaneous bone cement injection beyond the spine. Semin Interv Radiol 27:199–208

    Article  Google Scholar 

  2. Cazzato RL, Buy X, Eker O et al (2014) Percutaneous long bone cementoplasty of the limbs : experience with fifty-one non-surgical patients. Eur Radiol 24:3059–3068

    Article  PubMed  Google Scholar 

  3. Anselmetti GC, Manca A, Ortega C et al (2008) Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Intervent Radiol 31:1165–1173

    Article  PubMed  Google Scholar 

  4. Chang SW, Murphy KP (2005) Percutaneous CT-guided cementoplasty for stabilization of a femoral neck lesion. J Vasc Interv Radiol 6:889–890

    Article  Google Scholar 

  5. Basile A, Giuliano G, Scuderi V et al (2008) Cementoplasty in the management of painful extraspinal bone metastases: our experience. Radiol Med 113:1018–1028

    Article  CAS  PubMed  Google Scholar 

  6. Dayer R, Peter R. Percutaneous cementoplasty complicating the treatment of a pathologic subtrochanteric fracture: a case report. Injury.7:801–804

  7. Cazzato RL, Buy X, Eker O, Fabre T, Palussiere J (2014) Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients. Eur Radiol 24:3059–3068

    Article  PubMed  Google Scholar 

  8. Sun G, Jin P, Li M et al (2011) Percutaneous cementoplasty for painful osteolytic humeral metastases: initial experience with an innovative technique. Skelet Radiol 40:1345–1348

    Article  Google Scholar 

  9. Sun G, Jin P, Liu XW et al (2014) Cementoplasty for managing painful bone metastases outside the spine. Eur Radiol 24:731–737

    Article  PubMed  Google Scholar 

  10. Kawai N, Sato M, Iwamoto T et al (2007) Percutaneous cementoplasty with use of a cement-filled catheter for a pathologic fracture of the humerus. J Vasc Interv Radiol 18:805–809

    Article  PubMed  Google Scholar 

  11. Wedin R, Bauer HC (2005) Surgical treatment of skeletal metastatic lesions of the proximal femur. Endoprosthesis or reconstruction nail? J Bone Joint Surg 87B:1653–1657

    Article  Google Scholar 

  12. Jawad MU, Scully SP (2010) In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. Clin Orthop Relat Res 468:2825–2827

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mirels H (1989) Metastatic disease in long bones. A proposed scoring sys-tem for diagnosing impending pathologic fractures. Clin Orthop Relat Res 249:256–264

    Google Scholar 

  14. Van der Linden YM, Dijkstra PD, Kroon HM et al (2004) Comparative analysis of risk factors for pathological fracture with femoral metastases. J Bone Joint Surg (Br) 86:566–573

    Google Scholar 

  15. Ristevski B, Jenkinson RJ, Stephen DJ et al (2009) Mortality and complications following stabilization of femoral metastatic lesions: a population-based study of regional variation and outcome. Can J Surg 52(4):302–308

    PubMed  PubMed Central  Google Scholar 

  16. Gangi A, Buy X (2010) Percutaneous bone tumor management. Semin Intervent Radiol 27:124–136

    Article  PubMed  PubMed Central  Google Scholar 

  17. Heini PF, Franz T, Fankhauser C et al (2004) Femoroplasty- augmentation of mechanical properties in the osteoporotic proximal femur: a biomechanical investigation of PMMA reinforcement in cadaver bones. Clin Biomech 19:506–512

    Article  Google Scholar 

  18. Sutter EG, Mears SC, Belkoff SM (2010) A biomechanical evaluation of femoroplasty under simulated fall conditions. J Orthop Trauma 24:95–99

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kelekis A, Filippiadis D, Anselmetti G, Brountzos E (2015) Percutaneous augmented peripheral osteoplasty in long bones of oncologic patients for pain reduction and prevention of impeding pathologic fracture: the rebar concept. Cardiovasc Intervent Radiol (Epub ahead of print)

  20. Kim JH, Kang HG, Kim JR, Lin PP (2011) Minimally invasive surgery of humeral metastasis using flexible nails and cement in high-risk patients withadvanced cancer. Surg Oncol 20:e32–e37

    Article  PubMed  Google Scholar 

  21. Anselmetti GC, Manca A, Chiara G, Tutton S (2011) Painful pathologic fracture of the humerus:percutaneous osteoplasty with bone marrow nails under hybridcomputed tomography and fluoroscopic guidance. J Vasc Interv Radiol 22:1031–1034

  22. Deschamps F, Farouil G, Hakime A, Teriitehau C et al (2012) Percutaneous stabilization of impending pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 35:1428–1432

    Article  PubMed  Google Scholar 

  23. Vegt P, Muir JM, Block JE (2014) The photodynamic bone stabilization system: a minimally invasive, percutaneous intramedullary polymericosteosynthesis for simple and complex long bone fractures. Med Devices (Auckl) 7:453–461

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Acknowledgments

The scientific guarantor of this publication is Gang Sun. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study was supported by Grant Nos. 51073173 from the National Nature Science Foundation of China (NNSFC) and 2013AA032203 from the National High Technology Research and Development Program of China (863 programme). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, multicentre study.

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    Authors and Affiliations

    1. Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China

      Xun-wei Liu, Peng Jin, Kai Liu, Li Li, Min LI & Gang Sun

    2. Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China

      Hao Chen & Hai Tang

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    1. Xun-wei Liu
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    2. Peng Jin
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    3. Kai Liu
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    5. Li Li
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    6. Min LI
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    8. Gang Sun
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    Correspondence to Hai Tang or Gang Sun.

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    Xun-wei Liu and Peng Jin contributed equally to this work.

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    Liu, Xw., Jin, P., Liu, K. et al. Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture. Eur Radiol 27, 120–127 (2017). https://doi.org/10.1007/s00330-016-4347-x

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    • DOI: https://doi.org/10.1007/s00330-016-4347-x

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