Back to Search
Start Over
Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus.
- Source :
-
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2016 Oct; Vol. 39 (10), pp. 1455-63. Date of Electronic Publication: 2016 Jun 02. - Publication Year :
- 2016
-
Abstract
- Aim: To review outcomes and local evolution of treated lesions following percutaneous image-guided screw fixation (PIGSF) of pathological/insufficiency fractures (PF/InF) and impeding fractures (ImF) in cancer patients at two tertiary centres.<br />Materials and Methods: Thirty-two consecutive patients (mean age 67.5 years; range 33-86 years) with a range of tumours and prognoses underwent PIGSF for non/minimally displaced PF/InF and ImF. Screws were placed under CT/fluoroscopy or cone-beam CT guidance, with or without cementoplasty. Clinical outcomes were assessed using a simple 4-point scale (1 = worse; 2 = stable; 3 = improved; 4 = significantly improved). Local evolution was reviewed on most recent follow-up imaging. Technical success, complications, and overall survival were evaluated.<br />Results: Thirty-six lesions were treated with 74 screws mainly in the pelvis and femoral neck (58.2 %); including 47.2 % PF, 13.9 % InF, and 38.9 % ImF. Cementoplasty was performed in 63.9 % of the cases. Technical success was 91.6 %. Hospital stay was ≤3 days; 87.1 % of lesions were improved at 1-month follow-up; three major complications (early screw-impingement radiculopathy; accelerated coxarthrosis; late coxofemoral septic arthritis) and one minor complication were observed. Unfavourable local evolution at imaging occurred in 3/24 lesions (12.5 %) at mean 8.7-month follow-up, including poor consolidation (one case) and screw loosening (two cases, at least 1 symptomatic). There were no cases of secondary fractures.<br />Conclusions: PIGSF is feasible for a wide range of oncologic patients, offering good short-term efficacy, acceptable complication rates, and rapid recovery. Unfavourable local evolution at imaging may be relatively frequent, and requires close clinico-radiological surveillance.
- Subjects :
- Adult
Aged
Aged, 80 and over
Bone Neoplasms mortality
Cementoplasty
Cone-Beam Computed Tomography
Female
Fluoroscopy
Follow-Up Studies
Fractures, Spontaneous mortality
Humans
Male
Middle Aged
Postoperative Complications diagnosis
Postoperative Complications etiology
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome
Bone Neoplasms secondary
Bone Neoplasms surgery
Bone Screws
Fracture Fixation, Internal methods
Fractures, Spontaneous surgery
Minimally Invasive Surgical Procedures methods
Surgery, Computer-Assisted methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-086X
- Volume :
- 39
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cardiovascular and interventional radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27256104
- Full Text :
- https://doi.org/10.1007/s00270-016-1389-z