Percutaneous osteoplasty in long bones: Current status and assessment of outcomes

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Techniques in Vascular and Interventional Radiology Pub Date : 2022-03-01 DOI:10.1016/j.tvir.2022.100803

Roberto Luigi Cazzato MD, PhD , Julien Garnon MD, PhD , Danoob Dalili MD , Pierre-Alexis Autrusseau MD , Pierre Auloge MD , Pierre De Marini MD , Xavier Buy MD , Jean Palussiere MD , Afshin Gangi MD, PhD

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引用次数: 2

Abstract

Osteoplasty is a minimally invasive imaging-guided intervention providing mechanical stabilization, bone consolidation and pain relief in oncologic patients presenting with non-osteoblastic bone metastases or with insufficiency fractures. The intervention relies on the injection of an acrylic substance (ie, polymethylmethacrylate; PMMA) into the target bone.

PMMA is very resistant to axial compressive loads but much less to bending, torsional and shearing stresses. Accordingly, from a biomechanical standpoint osteoplasty is adapted for the palliative treatment of small painful lytic bone defects located in the epiphyseal region of long bones in patients with clear surgical contraindications; or for increasing the anchoring of the osteosynthesis material into the target bone.

Although pain relief is rapid and effective following osteoplasty, secondary fractures have been reported in up to 8-9% of long bone tumors undergoing such intervention; and following such event, fixation with endomedullary osteosynthetic material (eg, nailing) is not practicable any more. Accordingly, careful patients’ selection is critical and should happen with a multidisciplinary approach.

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长骨经皮骨成形术:现状和结果评估。

骨成形术是一种微创成像引导干预，为出现非成骨细胞骨转移或不完全性骨折的肿瘤患者提供机械稳定、骨巩固和疼痛缓解。干预依赖于注射丙烯酸物质(即聚甲基丙烯酸甲酯;PMMA)进入目标骨。PMMA对轴向压缩载荷有很强的抵抗能力，但对弯曲、扭转和剪切应力的抵抗能力要弱得多。因此，从生物力学的角度来看，骨成形术适用于有明确手术禁忌症的长骨骨骺区小而痛的溶解性骨缺损的姑息性治疗;或者增加骨合成材料在目标骨中的锚定。尽管骨成形术后疼痛缓解迅速有效，但据报道，8-9%的长骨肿瘤患者接受此类干预后继发性骨折;在这种情况下，髓内合成骨材料(如钉钉)的固定不再可行。因此，谨慎的患者选择是至关重要的，应该以多学科的方式进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.