Percutaneous Augmented Peripheral Osteoplasty in Long Bones of Oncologic Patients for Pain Reduction and Prevention of Impeding Pathologic Fracture: The Rebar Concept

Abstract

Percutaneous augmented peripheral osteoplasty (rebar concept) for symptomatic malignant lesions in long bones seems to be a possible new technique for bone stabilization. This combination seems to provide necessary stability against shearing forces applied in long bones during weight bearing.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

“…Augmentation of cementoplasty with internal fixation [13], metallic mesh [14,15], or K-wires [16] has also been suggested to be more efficient than stand-alone cementoplasty. However, these techniques lack in vitro-biomechanical evaluation and still require the use of cementoplasty to fix the fractures.…”

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

“…PIGSF with close clinical and radiological monitoring is therefore a viable option for a wide range of patients. Several alternative techniques have been described for percutaneous treatment of oncologic bone lesions, including internal fixation with modified trocars, bone marrow nails, Kirschner wires, and cement-filled catheters [29,[36][37][38][39]; and augmentation using micro-needles mesh and cement [40]. Although supported by some biomechanical evidence [41], these techniques have not widespread and clinical evidence is lacking.…”

“…Several alternative techniques have been described for percutaneous treatment of oncologic bone lesions, including internal fixation with modified trocars, bone marrow nails, Kirschner wires, and cement-filled catheters [29,[36][37][38][39]; and augmentation using micro-needles mesh and cement [40]. Although supported by some biomechanical evidence [41], these techniques have not widespread and clinical evidence is lacking. Conversely, screw fixation is commonly used by orthopaedic surgeons in patients unsuitable for invasive surgery in a variety of locations and settings [14,22,23,32,42].…”

Interventional Techniques for the Ablation and Augmentation of Extraspinal Lytic Bone Metastases

“…14 More experimental techniques in diaphyseal bone employ cementfilled catheters or flexible nails which are inserted into the medullae of long bones. 14,28 Treatment Considerations and Scoring Classifications…”

“…Functional improvement is achieved in nearly 80% of patients and there is limited evidence to suggest that cementoplasty with PS reduces the risk of pathologic fracture in the long bones. [12][13][14]…”