Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus.

Détails

ID Serval
serval:BIB_11413F0AB3A5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus.
Périodique
Cardiovascular and interventional radiology
Auteur(s)
Cazzato R.L., Koch G., Buy X., Ramamurthy N., Tsoumakidou G., Caudrelier J., Catena V., Garnon J., Palussiere J., Gangi A.
ISSN
1432-086X (Electronic)
ISSN-L
0174-1551
Statut éditorial
Publié
Date de publication
10/2016
Peer-reviewed
Oui
Volume
39
Numéro
10
Pages
1455-1463
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To review outcomes and local evolution of treated lesions following percutaneous image-guided screw fixation (PIGSF) of pathological/insufficiency fractures (PF/InF) and impeding fractures (ImF) in cancer patients at two tertiary centres.
Thirty-two consecutive patients (mean age 67.5 years; range 33-86 years) with a range of tumours and prognoses underwent PIGSF for non/minimally displaced PF/InF and ImF. Screws were placed under CT/fluoroscopy or cone-beam CT guidance, with or without cementoplasty. Clinical outcomes were assessed using a simple 4-point scale (1 = worse; 2 = stable; 3 = improved; 4 = significantly improved). Local evolution was reviewed on most recent follow-up imaging. Technical success, complications, and overall survival were evaluated.
Thirty-six lesions were treated with 74 screws mainly in the pelvis and femoral neck (58.2 %); including 47.2 % PF, 13.9 % InF, and 38.9 % ImF. Cementoplasty was performed in 63.9 % of the cases. Technical success was 91.6 %. Hospital stay was ≤3 days; 87.1 % of lesions were improved at 1-month follow-up; three major complications (early screw-impingement radiculopathy; accelerated coxarthrosis; late coxofemoral septic arthritis) and one minor complication were observed. Unfavourable local evolution at imaging occurred in 3/24 lesions (12.5 %) at mean 8.7-month follow-up, including poor consolidation (one case) and screw loosening (two cases, at least 1 symptomatic). There were no cases of secondary fractures.
PIGSF is feasible for a wide range of oncologic patients, offering good short-term efficacy, acceptable complication rates, and rapid recovery. Unfavourable local evolution at imaging may be relatively frequent, and requires close clinico-radiological surveillance.
Mots-clé
Adult, Aged, Aged, 80 and over, Bone Neoplasms/mortality, Bone Neoplasms/secondary, Bone Neoplasms/surgery, Bone Screws, Cementoplasty, Cone-Beam Computed Tomography, Female, Fluoroscopy, Follow-Up Studies, Fracture Fixation, Internal/methods, Fractures, Spontaneous/mortality, Fractures, Spontaneous/surgery, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures/methods, Postoperative Complications/diagnosis, Postoperative Complications/etiology, Surgery, Computer-Assisted/methods, Survival Rate, Tomography, X-Ray Computed, Treatment Outcome, Bone, Fractures, Screw fixation
Pubmed
Web of science
Création de la notice
09/10/2018 12:34
Dernière modification de la notice
20/08/2019 13:38
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