Amira Al Raaisi1, Kévin Premat1, Evelyne Cormier1, Eimad Shotar1, Mehdi Drir2, Véronique Morel3, Jean-Philippe Spano4,5, Hugues Pascal-Mousselard4,6, Laetitia Morardet5, Frédéric Clarençon7,8, Jacques Chiras9. 1. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, 47, Bd de l'Hôpital, 75013, Paris, France. 2. Department of Anesthesiology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France. 3. Department of Hematology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France. 4. Paris VI University, Sorbonne University, Paris, France. 5. Department of Oncology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France. 6. Department of Orthopedic Surgery, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France. 7. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, 47, Bd de l'Hôpital, 75013, Paris, France. fredclare5@gmail.com. 8. Paris VI University, Sorbonne University, Paris, France. fredclare5@gmail.com. 9. Clinique Bizet, Paris, France.
Abstract
OBJECTIVES: Pelvic bone pathological lesions and traumatic fractures are a considerable source of pain and disability. In this study, we sought to evaluate the effectiveness of reinforced cementoplasty (RC) in painful and unstable lesions involving the pelvic bone in terms of pain relief and functional recovery. METHODS: All patients with neoplastic lesion or pelvic fracture for whom a pelvic bone RC was carried out between November 2013 and October 2017 were included in our study. All patients who failed the medical management, patients unsuitable for surgery, and patients with unstable osteolytic lesions were eligible to RC. Clinical outcome was evaluated with a 1-month and 6-month post-procedure follow-up. The primary endpoint was local pain relief measured by the visual analogue scale (VAS). RESULTS: Twenty-two patients (18 females, 4 males; mean age of 65.4 ± 13.3 years [range 38-80]) presenting with painful and unstable pelvic lesions were treated by RC during the study period. Among the 22 patients, 8 patients presented with unstable pelvic fractures (3 patients with iliac crest fracture, 3 with sacral fractures, and the remaining 2 with peri-acetabular fractures). No procedure-related complications were recorded. All patients had significant pain relief and functional improvement at 1 month. One patient (4.5%) had suffered a secondary fracture due to local tumour progression. CONCLUSIONS: Reinforced cementoplasty is an original minimally invasive technique that may help in providing pain relief and effective bone stability for neoplastic and traumatic lesions involving the pelvic bone. KEY POINTS: • Reinforced cementoplasty is feasible in both traumatic fractures and tumoural bone lesions of the pelvis. • Reinforced cementoplasty for pelvic bone lesions provides pain relief and functional recovery. • Recurrence of pelvic bone fracture was observed in 4.5% of the cases in our series.
OBJECTIVES: Pelvic bone pathological lesions and traumatic fractures are a considerable source of pain and disability. In this study, we sought to evaluate the effectiveness of reinforced cementoplasty (RC) in painful and unstable lesions involving the pelvic bone in terms of pain relief and functional recovery. METHODS: All patients with neoplastic lesion or pelvic fracture for whom a pelvic bone RC was carried out between November 2013 and October 2017 were included in our study. All patients who failed the medical management, patients unsuitable for surgery, and patients with unstable osteolytic lesions were eligible to RC. Clinical outcome was evaluated with a 1-month and 6-month post-procedure follow-up. The primary endpoint was local pain relief measured by the visual analogue scale (VAS). RESULTS: Twenty-two patients (18 females, 4 males; mean age of 65.4 ± 13.3 years [range 38-80]) presenting with painful and unstable pelvic lesions were treated by RC during the study period. Among the 22 patients, 8 patients presented with unstable pelvic fractures (3 patients with iliac crest fracture, 3 with sacral fractures, and the remaining 2 with peri-acetabular fractures). No procedure-related complications were recorded. All patients had significant pain relief and functional improvement at 1 month. One patient (4.5%) had suffered a secondary fracture due to local tumour progression. CONCLUSIONS: Reinforced cementoplasty is an original minimally invasive technique that may help in providing pain relief and effective bone stability for neoplastic and traumatic lesions involving the pelvic bone. KEY POINTS: • Reinforced cementoplasty is feasible in both traumatic fractures and tumoural bone lesions of the pelvis. • Reinforced cementoplasty for pelvic bone lesions provides pain relief and functional recovery. • Recurrence of pelvic bone fracture was observed in 4.5% of the cases in our series.
Authors: Francis Y Lee; Igor Latich; Courtney Toombs; Alana Mungur; Devin Conway; Kareme Alder; Izuchukwu Ibe; Dieter Lindskog; Gary Friedlaender Journal: J Vasc Interv Radiol Date: 2020-03-03 Impact factor: 3.464