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European Radiology

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01-12-2014 | Interventional

Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients

Authors: Roberto Luigi Cazzato, Xavier Buy, Omer Eker, Thierry Fabre, Jean Palussiere

Published in: European Radiology | Issue 12/2014

Abstract

Objective

To review our 10-year experience with percutaneous long bone cementoplasty (PLBC) in poor surgical patients.

Materials and methods

Fifty-one patients were included. Primary endpoints were pain and functional outcomes one month following PLBC. A secondary endpoint dealt with factors predicting cement leakage. Delayed adverse events and overall survival (OS) were also investigated.

Results

Sixty-six lesions were treated. Local pain relief at 1-month occurred in 59/66 lesions (89.4 %); pain improvement was significantly more common for lesions of the upper limb (p < 0.05). Limb functionality at one month improved in 46/64 lesions (71.8 %); lesions ≤ 3 cm showed better outcomes in terms of limb function (p <0.05). Cement leakage was minor and asymptomatic in 26 cases (26/66, 39.4 %); in one case (1/66, 1.5 %) symptomatic minor amount of intra-articular cement leakage occurred. Factors predicting cement leakage were diaphyseal location of the lesions, cortical bone disruption and extra-bone tumour extension (p < 0.05). The most common delayed adverse event was fracture (6/66, 9.1 %). OS at 1-, 2- and 3-years was 61.2 %, 30.9 % and 23.0 %, respectively.

Conclusions

For poor surgical candidates, at 1-month follow-up, PLBC proved to be safe and effective. If stress fracture occurs following PLBC, surgical external fixation is still an affordable therapeutic option.

Key Points

• Percutaneous long bone cementoplasty may be proposed to poor surgical patients

• Pain palliation is more significant for lesions of the upper limb

• Limb function improves significantly for lesions sized ≤ 3 cm

• Fracture is the most common delayed adverse event (9 % of cases)

• If cement stress fracture occurs, surgical external fixation is still feasible

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Title: Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients
Authors: Roberto Luigi Cazzato
Xavier Buy
Omer Eker
Thierry Fabre
Jean Palussiere
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3357-9

At a glance: The STEP trials

Springer Medicine

Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients

Abstract

Objective

Materials and methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

Key Points

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