Skip to main content

Advertisement

Log in

Cementoplasty for managing painful bone metastases outside the spine

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

Abstract

Objective

To illustrate the effect of treatment with cementoplasty in patients with painful bone metastases in the extraspinal region.

Methods

A retrospective study was conducted to review 51 consecutive patients who underwent cementoplasty under CT or fluoroscopic guidance, a total of 65 lesions involving the ilium, ischium, pubis, acetabulum, humeral, femur and tibia. In 5 patients with a high risk of impending fracture in long bones based on Mirels’ scoring system, an innovative technique using a cement-filled catheter was applied. The clinical effects were evaluated using the visual analogue scale (VAS) preoperatively and postoperatively.

Results

All patients were treated successfully with a satisfying resolution of painful symptoms at 3 months’ follow-up. Cement leakage was found in 8 lesions without any symptoms. VAS scores decreased from 8.19 ± 1.1 preoperatively to 4.94 ± 1.6 at 3 days, 3.41 ± 2.1 at 1 month and 3.02 ± 1.9 at 3 months postoperatively. There was a significant difference between the mean preoperative baseline score and the mean score at all of the postoperative follow-up points (P < 0.01).

Conclusions

Cementoplasty is an effective technique for treating painful bone metastases in extraspinal regions, which is a valuable, minimally invasive, method that allows reduction of pain and improvement of patients’ quality of life.

Key Points

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

Cement-filled catheter resulted in a fixation effect to prevent pathological fractures.

Cementoplasty resulted in significant pain relief in patients with extraspinal metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Gilbert HA, Kagan AR, Nussbaum H et al (1977) Evaluation of radiation therapy for bone metastases: pain relief and quality of life. AJR Am J Roentgenol 129:1095–1096

    Article  CAS  PubMed  Google Scholar 

  2. Ross JR, Saunders Y, Edmonds PM, Patel S, Broadley KE, Johnston SR (2003) Systematic review of role of bisphosphonates on skeletal morbidity in metastatic cancer. BMJ 327:469–474

    Article  CAS  PubMed  Google Scholar 

  3. Meuser T, Pietruck C, Radbruch L, Stute P, Lehmann KA, Grond S (2003) Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain 93:247–257

    Article  Google Scholar 

  4. Jacofsky DJ, Papagelopoulos PJ, Sim FH (2003) Advances and challenges in the surgical treatment of metastatic bone disease. Clin Orthop Relat Res 415:S14–S18

    Article  PubMed  Google Scholar 

  5. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    CAS  PubMed  Google Scholar 

  6. Peh WC, Munk PL, Rashid F, Gilula LA (2008) Percutaneous vertebral augmentation: vertebroplasty, kyphoplasty and skyphoplasty. Radiol Clin N Am 46:611–635

    Article  PubMed  Google Scholar 

  7. Anselmetti GC, Manca A, Ortega C, Grignani G, Debernardi F, Regge D (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 

  8. Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL (2003) Percutaneous vertebroplasty: indications, technique, and results. Radiographics 23:e10

    Article  PubMed  Google Scholar 

  9. Hierholzer J, Anselmetti G, Fuchs H, Depriester C, Koch K, Pappert D (2003) Percutaneous osteoplasty as a treatment for painful malignant bone lesions of the pelvis and femur. J Vasc Interv Radiol 14:773–777

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  11. Mirels H (1989) Metastatic disease in long bones: a proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 249:256–264

    PubMed  Google Scholar 

  12. Sun G, Jin P, Li M, Lu Y et al (2011) Percutaneous vertebroplasty for pain management in spinal metastasis with epidural involvement. Technol Cancer Res Treat 10:267–274

    CAS  PubMed  Google Scholar 

  13. 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 

  14. Cotten A, Deprez X, Migaud H, Chabanne B, Duquesnoy B, Chastanet P (1995) Malignant acetabular osteolyses: percutaneous injection of acrylic bone cement. Radiology 197:307–310

    CAS  PubMed  Google Scholar 

  15. Kawai N, Sato M, Iwamoto T, Tanihata H, Minamiguti H, Nakata K (2007) Percutaneous osteoplasty 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 

  16. Baroud G, Samara M, Steffen T (2004) Influence of mixing method on the cement temperature-mixing time history and doughing time of three acrylic cements for vertebroplasty. J Biomed Mater Res B Appl Biomater 68:112–116

    Article  CAS  PubMed  Google Scholar 

  17. Belkoff SM, Molloy S (2003) Temperature measurement during polymerization of polymethylmethacrylate cement used for vertebroplasty. Spine (Phila Pa 1976) 28:1555–1559

    Google Scholar 

  18. 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 

Download references

Acknowledgements

All authors stated that they had no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gang Sun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sun, G., Jin, P., Liu, Xw. et al. Cementoplasty for managing painful bone metastases outside the spine. Eur Radiol 24, 731–737 (2014). https://doi.org/10.1007/s00330-013-3071-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-013-3071-z

Keywords

Navigation