Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture.
OBJECTIVE
To compare the efficacy of percutaneous long bone cementoplasty (PLBC) with and without embedding a cement-filled catheter in the medullary canal (ECFC) for painful long bone metastases with impending fracture.


METHODS
A retrospective study was conducted in 36 consecutive patients undergoing PLBC and ECFC combination (n = 17, group A) or PLBC alone (n = 19, group B). All patients had a high risk of impending fracture in the long bone based on Mirels' scoring system. Clinical effects were evaluated using both a pre- and a postoperative visual analogue scale (VAS) and Karnofsky performance scale (KPS).


RESULTS
Overall pain relief rate with excellent (VAS 0-2) and good (VAS 2.5-4.5) results during follow-up was significantly higher in group A than in group B (88.2 % vs. 57.9 %, P<0.05). The average VAS and KPS changes in group A were significantly higher than those in group B at 1, 3 and 6 months postoperatively (P<0.05). Also, the rate of fractures of the treated long bone in group A was significantly lower than that in group B (P<0.05).


CONCLUSIONS
Combined PLBC and ECFC is a safe and effective procedure for long bone metastases with impending fracture.


CONCLUSIONS
• Metastases in long bones may cause pain and subsequent pathological fractures. • Cementoplasty resulted in significant pain relief in patients with long bone metastases. • Combination of PLBC and ECFC may reduce the incidence of fractures.
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China.
Xun-Wei
XW
Liu
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China.
Peng
P
Jin
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China.
Kai
K
Liu
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China.
Hao
H
Chen
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China.
Li
L
Li
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China.
Min
M
Li
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China. tanghai@medmail.com.cn.
Hai
H
Tang
Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong Province, 250031, China. cjr.sungang@vip.163.com.
Gang
G
Sun
D000368:Aged; D001843:Bone Cements / Q000494:pharmacology*; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D057785:Catheters; D060826:Cementoplasty / Q000379:methods*; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D001843:Bone Cements
Cementoplasty; Interventional internal fixation; Long bone; Pain; Pathological fracture