title: CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture.
abstract: OBJECTIVE
  To evaluate the feasibility and effectiveness of computed tomography (CT)-guided percutaneous screw fixation plus cementoplasty (PSFPC), for either treatment of painful metastatic fractures or prevention of pathological fractures, in patients who are not candidates for surgical stabilization.
  
  
  METHODS
  Twenty-seven patients with 34 metastatic bone lesions underwent CT-guided PSFPC. Bone metastases were located in the vertebral column, femur, and pelvis. The primary end point was the evaluation of feasibility and complications of the procedure, in addition to the length of hospital stay. Pain severity was estimated before treatment and 1 and 6 months after the procedure using the visual analog scale (VAS). Functional outcome was assessed by improved patient walking ability.
  
  
  RESULTS
  All sessions were completed and well tolerated. There were no complications related to either incorrect positioning of the screws during bone fixation or leakage of cement. All patients were able to walk within 6 h after the procedure and the average length of hospital stay was 2 days. The mean VAS score decreased from 7.1 (range, 4-9) before treatment to 1.6 (range, 0-6), 1 month after treatment, and to 1.4 (range 0-6) 6 months after treatment. Neither loosening of the screws nor additional bone fractures occurred during a median follow-up of 6 months.
  
  
  CONCLUSIONS
  Our results suggest that PSFPC might be a safe and effective procedure that allows the stabilization of the fracture and the prevention of pathological fractures with significant pain relief and good recovery of walking ability, although further studies are required to confirm this preliminary experience.
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, 09100, Italy. clapusceddu@gmail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pusceddu
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fancellu
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, 09100, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ballicu
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, 09100, Italy.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Fele
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, 09100, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sotgia
authors.affiliation: Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, 09100, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Melis
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D001863:Bone Screws; D060826:Cementoplasty / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Bone metastases; Cementoplasty; Drill; Interventional radiology; Pathological fractures; Percutaneous screw fixation