Percutaneous Long Bone Cementoplasty of the Limbs: Experience With Fifty-One Non-Surgical Patients

Eur Radiol. 2014 Dec;24(12):3059-68. doi: 10.1007/s00330-014-3357-9. Epub 2014 Aug 6.

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arm Bones
  • Bone Cements / therapeutic use
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery*
  • Cementoplasty / methods*
  • Female
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / surgery*
  • Humans
  • Leg Bones
  • Male
  • Middle Aged
  • Musculoskeletal Pain / drug therapy
  • Pain Management / methods
  • Polymethyl Methacrylate / therapeutic use
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Bone Cements
  • Polymethyl Methacrylate