title: Percutaneous Augmented Peripheral Osteoplasty in Long Bones of Oncologic Patients for Pain Reduction and Prevention of Impeding Pathologic Fracture: The Rebar Concept.
abstract: OBJECTIVE
  To evaluate clinical efficacy/safety of augmented peripheral osteoplasty in oncologic patients with long-term follow-up.
  
  
  METHODS
  Percutaneous augmented peripheral osteoplasty was performed in 12 patients suffering from symptomatic lesions of long bones. Under extensive local sterility measures, anesthesiology care, and fluoroscopic guidance, direct access to lesion was obtained and coaxially a metallic mesh consisting of 25-50 medical grade stainless steel micro-needles (22 G, 2-6 cm length) was inserted. PMMA for vertebroplasty was finally injected under fluoroscopic control. CT assessed implant position 24-h post-treatment.
  
  
  RESULTS
  Clinical evaluation included immediate and delayed follow-up studies of patient's general condition, NVS pain score, and neurological status. Imaging assessed implant's long-term stability. Mean follow-up was 16.17 ± 10.93 months (range 2-36 months). Comparing patients' scores prior (8.33 ± 1.67 NVS units) and post (1.42 ± 1.62 NVS units) augmented peripheral osteoplasty, there was a mean decrease of 6.92 ± 1.51 NVS units. Overall mobility improved in 12/12 patients. No complication was observed.
  
  
  CONCLUSIONS
  Percutaneous augmented peripheral osteoplasty (rebar concept) for symptomatic malignant lesions in long bones seems to be a possible new technique for bone stabilization. This combination seems to provide necessary stability against shearing forces applied in long bones during weight bearing.
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece. akelekis@med.uoa.gr.
authors.forename: A
authors.initials: A
authors.lastname: Kelekis
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece. dfilippiadis@yahoo.gr.
authors.forename: D
authors.initials: D
authors.lastname: Filippiadis
authors.affiliation: GVM Care and Research Maria Pia Hospital, Strada Comunale di Mongreno 180, 10132, Turin, Italy. gc.anselmetti@fastwebnet.it.
authors.forename: G
authors.initials: G
authors.lastname: Anselmetti
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece. ebrountz@med.uoa.gr.
authors.forename: E
authors.initials: E
authors.lastname: Brountzos
authors.affiliation: A Orthopedic Clinic, University General Hospital "ATTIKON", Athens, Greece. afm@otenet.gr.
authors.forename: A
authors.initials: A
authors.lastname: Mavrogenis
authors.affiliation: A Orthopedic Clinic, University General Hospital "ATTIKON", Athens, Greece. pjp@hol.gr.
authors.forename: P
authors.initials: P
authors.lastname: Papagelopoulos
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece. kelnik@med.uoa.gr.
authors.forename: N
authors.initials: N
authors.lastname: Kelekis
authors.affiliation: Centre Imaginerie Rive Droite & Gauche, Geneva, Switzerland. jbmartin@cird.ch.
authors.forename: J-B
authors.initials: JB
authors.lastname: Martin
mesh_terms: D060826:Cementoplasty / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000517:prevention & control*; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging / Q000473:pathology
keywords: Cancer; Musculoskeletal; Non-Vascular Interventions; Osteoplasty; Pain; Pain Management