title: Percutaneous cementoplasty for the treatment of extraspinal painful bone lesion, a prospective study.
abstract: OBJECTIVE
  The current gold standard treatment of localized painful bone lesion is radiotherapy but this technique has limitations. Our study aims to demonstrate that cementoplasty is an efficient alternative for these palliatives indications when lesions involve extraspinal bones. We prospectively followed 20 patients who received a percutaneous cementoplasty on painful lytic bone lesions between May 2008 and May 2010.
  
  
  METHODS
  Seventeen patients also had difficulty walking in relation to the pain experienced. The clinical indication for treatment was severe pain (≥4 on the numeric scale) due to bone lesion on CT or MRI. All procedures (except one) were performed under local anesthesia.
  
  
  RESULTS
  Feasibility was 100% without immediate complications. The patients experienced a significant and rapid decrease of their pain (4.1 points, P<000.1) and this effect was sustained over the long term (7.75 months of follow-up on average). Sixty-four percent of patients treated on the lower limbs and pelvis improved mobility.
  
  
  CONCLUSIONS
  In our experience, percutaneous cementoplasty may be a safe and effective palliative treatment for localized painful lytic lesion. Combining CT and fluoroscopic guidance seems to be the safer option because of extravertebral localization. Smart fill of the bone and careful selection of patient determine the effectiveness of the procedure. Diffuse painful lesions and long bone diaphysis should not be good indications.
authors.affiliation: Département de Radiodiagnostic et Radiologie Interventionnelle Oncologique, Centre de Lutte Contre le Cancer Antoine-Lacassagne, 33 avenue de Valombrose, Nice cedex 02, France. antoineiannessi@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Iannessi
authors.forename: N
authors.initials: N
authors.lastname: Amoretti
authors.forename: P-Y
authors.initials: PY
authors.lastname: Marcy
authors.forename: J
authors.initials: J
authors.lastname: Sedat
mesh_terms: D000077:Acetabulum / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary* / Q000601:surgery*; D060826:Cementoplasty / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery; D007085:Ilium / Q000000981:diagnostic imaging / Q000601:surgery; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010014:Osteolysis / Q000175:diagnosis / Q000601:surgery*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed