Driven around the bend: novel use of a curved steerable needle.
OBJECTIVE
This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles.


METHODS
Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum.


RESULTS
All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients.


CONCLUSIONS
Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles.
Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada. darra.murphy@vch.ca
Darra T
DT
Murphy
Jeffrey R
JR
Korzan
Hugue A
HA
Ouellette
David M
DM
Liu
Paul W
PW
Clarkson
Peter L
PL
Munk
D000077:Acetabulum; D001843:Bone Cements / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D054893:Cone-Beam Computed Tomography; D004867:Equipment Design; D005471:Fluoroscopy; D006801:Humans; D009339:Needles; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D012447:Sacrum; D016896:Treatment Outcome
D001843:Bone Cements