Management of metastatic bone disease (MBD)

Trompeter, Alex

doi:10.1016/j.injury.2022.09.054

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Metastatic Bone Disease (MBD), the spread of cancer cells from a primary tumour to bone, typically results in pain, pathological fractures, hypercalcaemia, spinal cord compression and other complications with signi cant impact on patients' quality of life [1][2][3][4]. Due to better cancer survival rates the number of patients presenting with MBD is increasing and projections estimate a total of 2.5 million cancer patients in 2040 in the UK [5]. The most common visceral carcinomas causing orthopaedically relevant bone metastases are breast (28%), lung (17%) and renal (15%) cancers [6].…”

Section: Introductionmentioning

confidence: 99%

Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: A case series

Unthan,

Marintschev,

Spiegel

et al. 2024

Preprint

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Background Metastatic bone disease (MBD) and its complications have a significant impact on patients' quality of life. Pathological fractures are a particular problem as they affect patient mobility and pose a high risk of non-union. The pelvis is frequently affected by MBD and its fixation is challenging. We present a case series of three pathological sacral fractures treated with a new minimally invasive bilateral fixed angle locking system. Case presentation Case 1 and 2 suffered a pathological transforaminal sacral fracture without adequate trauma in stage 4 carcinomas (gastric cancer and breast cancer). Both were initially treated with non-surgical treatment, which had only a limited effect and led to imminent immobility. Both were operated on with fluoroscopic navigation and underwent transsacral SACRONAIL® stabilisation according to CT morphology (S1 + S2 and S1 respectively). Immediately after the operation, pain decreased and mobilisation improved. Case 3 had a pathological transalar sacral fracture during the 2nd cycle of chemotherapy due to non-Hodgkin's lymphoma. He soon became immobile and could only move in a wheelchair. The operation was performed with CT navigation due to the very small corridors and an implant was inserted in S1 and S2. The patient reported immediate pain relief and his ability to walk improved over the following months. Despite continued chemotherapy, no wound complications occurred. Conclusions The cases show the advantages of the minimally invasive bilateral fixed angle locking system SACRONAIL® in the treatment of patients with pathological sacral fractures. It allows immediate full weight bearing and the risk of secondary surgical complications is low. All cases showed an improvement in pain scores and mobility.

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Section: Introductionmentioning

confidence: 99%

Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: A case series

Unthan,

Marintschev,

Spiegel

et al. 2024

Preprint

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show abstract

“…The long bones of the limbs are frequently affected by bone metastases, and the femoral shaft is the most frequently affected site, accounting for 25% to 71% of long bone metastases, 25% of which lead to pathological fracture ( 1 ). Metastases in the femoral shaft can result in excruciating pain, limb impairment, and lower quality of life ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of customized modular prosthesis in the treatment of femoral shaft metastases

Shao

et al. 2023

Front. Oncol.

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PurposeTo examine clinical outcomes of a specialized modular prosthesis used to fill a bone deficiency following removal of femoral shaft metastases.MethodsEighteen patients with femoral shaft metastases who underwent en bloc resection and implantation of a personalized modular prosthesis between December 2014 and December 2019 were retrospectively analyzed. Pain, limb function, and quality of life were evaluated using the visual analog scale (VAS), Musculoskeletal Tumor Society (MSTS) scale, International Society of Limb Salvage (ISOLS) scoring system, Karnofsky Performance Status (KPS) scale, and Nottingham Health Profile (NHP) scale. The Kaplan–Meier technique was used to analyze patient survival.ResultsThe operation duration was 90–150 min (mean, 115 min), and the osteotomy length was 9–16 cm (mean, 11.72 cm). The patients were followed for 12–62 months (mean, 25.28 months). The VAS and NHP ratings were lower at 3, 6, and 12 months after surgery than before surgery, while the MSTS, ISOLS, and KPS scores were higher after surgery than they had been before. These differences were statistically significant (P<0.05). The survival period was between 7 and 62 months (mean, 20.89 months), and the rates of survival at 1-year and 2-year were 72.22% and 27.78%, respectively. Except for two patients with aseptic prosthesis loosening during the follow-up period, there were no problems.ConclusionEn bloc excision and implantation of a personalized modular prosthesis can reduce pain and improve the ability of patients with femoral shaft metastases to perform daily activities, thereby improving their quality of life.

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Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: a case series

Unthan,

Marintschev,

Spiegel

et al. 2024

World J Surg Onc

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Background Metastatic bone disease (MBD) and its complications have a significant impact on patients’ quality of life. Pathological fractures are a particular problem as they affect patient mobility and pose a high risk of non-union. The pelvis is frequently affected by MBD and its fixation is challenging. We present a case series of three pathological sacral fractures treated with a new minimally invasive bilateral fixed angle locking system. Case presentation Case 1 and 2 suffered a pathological transforaminal sacral fracture without adequate trauma in stage 4 carcinomas (gastric cancer and breast cancer). Both were initially treated with non-surgical treatment, which had only a limited effect and led to imminent immobility. Both were operated on with fluoroscopic navigation and underwent transsacral SACRONAIL® stabilisation according to CT morphology (S1 + S2 and S1 respectively). Immediately after the operation, pain decreased and mobilisation improved. Case 3 had a pathological transalar sacral fracture during the 2nd cycle of chemotherapy due to non-Hodgkin’s lymphoma. He soon became immobile and could only move in a wheelchair. The operation was performed with CT navigation due to the very small corridors and an implant was inserted in S1 and S2. The patient reported immediate pain relief and his ability to walk improved over the following months. Despite continued chemotherapy, no wound complications occurred. Conclusions The cases show the advantages of the minimally invasive bilateral fixed angle locking system SACRONAIL® in the treatment of patients with pathological sacral fractures. It allows immediate full weight bearing and the risk of secondary surgical complications is low. All cases showed an improvement in pain scores and mobility.

show abstract

Management of metastatic bone disease (MBD)

Cited by 3 publications

References 9 publications

Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: A case series

Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: A case series

Clinical efficacy of customized modular prosthesis in the treatment of femoral shaft metastases

Use of a newly developed minimally invasive bilateral fixed angle locking system in the treatment of pathological pelvic fractures: a case series

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