The role and biology of cryosurgery in the treatment of bone tumors. A review.
The application of liquid nitrogen as a local adjuvant to curettage in the treatment of bone tumors was introduced three decades ago. This technique, termed cryosurgery, was shown to achieve excellent local control in a variety of benign-aggressive and malignant bone tumors. However, early reports showed that cryosurgery was associated with a significant injury to the adjacent rim of bone and soft-tissue, resulting in high rates of fractures and infections. These results reflected an initial failure to appreciate the potentially destructive effects of liquid nitrogen and establish appropriate guidelines for its use. We review the biological effect of cryosurgery on bone, surgical technique, and current indications for its use.
Bickels
J
J
Department of Orthopedic Oncology, Washington Cancer Institute, Washington Hospital Center, Washington DC 20010, USA.
Meller
I
I
Shmookler
B M
BM
Malawer
M M
MM
D001843:Bone Cements / Q000627:therapeutic use; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D003475:Curettage / Q000379:methods; D006801:Humans; D018579:Patient Selection; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate