Percutaneous hollow screw internal fixation combined with cementoplasty in treatment of periacetabular metastasis / 中国修复重建外科杂志

OBJECTIVE@#To explore the percutaneous hollow screw internal fixation combined with cementoplasty in the treatment of periacetabular metastasis.@*METHODS@#A retrospective study was performed on 16 patients with periacetabular metastasis who were treated with percutaneous hollow screw internal fixation combined with cementoplasty between May 2020 and May 2021. There were 9 males and 7 females. The age ranged from 40 to 73 years, with an average of 53.6 years. The tumor involved around the acetabulum, and 6 cases were located on the left and 10 cases on the right. Operation time, frequency of fluoroscopy, bed rest time, and complications were recorded. Before operation, and at 1 weeks, 3 months after operation, the visual analogue scale (VAS) score was used to evaluate the pain degree, the short-form 36 health survey scale (SF-36) score was used to evaluate the quality of life. At 3 months after operation, the Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate the functional recovery of patients. During follow-up, the loosening of internal fixator and bone cement leakage were observed by X-ray film.@*RESULTS@#All patients were performed operation successfully. The operation time ranged from 57 to 82 minutes, with an average of 70.4 minutes. The frequency of intraoperative fluoroscopy was 16-34 times, with an average of 23.1 times. After operation, 1 case of incision hematoma and 1 case of scrotal edema occurred. All patients felt the pain relieved after operation. The patients started walking at 1-3 days after operation, with an average of 1.4 days. All patients were followed up 6-12 months (mean 9.7 months). The VAS and SF-36 scores significantly improved after operation when compared with the preoperative scores, and the scores at 3 months after operation were significant better than those at 1 week after operation ( P<0.05). At 3 months after operation, the MSTS score ranged from 9 to 27, with an average of 19.8. Among them, 3 cases were excellent (18.75%), 8 cases were good (50%), 3 cases were fair (18.75%), and 2 cases were poor (12.5%). The excellent and good rate was 68.75%. And 11 patients returned to normal walking, 3 had mild claudication, and 2 had obvious claudication. Radiological examination showed that there were 2 cases of bone cement leakage after operation, and there was no internal fixator loosening or displacement.@*CONCLUSION@#Percutaneous hollow screw internal fixation combined with cementoplasty can effectively relieve pain and improve the quality of life of patients with periacetabular metastasis.

Progress of image-guided physical ablation and percutaneous cementoplasty for bone metastatic pain / 中国介入影像与治疗学

About 50% malignant tumors may develop bone metastasis in advanced stage. Pain, pathological fractures and dysmotility are the main symptoms of patients with bone metastasis. Image-guided physical ablation can obviously relieve pain caused by bone metastasis, whereas imaging-guided bone cementoplasty can enhance bone stability, and has good effect on preventing and treating osteoporosis and pathological fractures. The progress of imaging-guided physical ablation, bone cementoplasty and the combination of two techniques in treatment of bone metastasis were reviewed in this article.

Progress of percutaneous cementoplasty for bone metastases / 中国介入影像与治疗学

Percutaneous cementoplasty has been widely used to treat bone metastases in clinic, with the main purpose of relieve pain and other symptoms. However, in addition to routine complications, there were still some other problems, such as local insufficient antitumor effect and even promoting tumor progress. Combining with physical ablation, arterial embolism, metal implantation, radiotherapy or other means may be helpful to improve the curative effect of percutaneous cementoplasty. The present situation, existing problems and combined application of bone cement in treatment of bone metastases were reviewed in this article.