Percutaneous Cement Augmentations of Malignant Lesions of the Sacrum and Pelvis: Fig 1.

Georgy, Bassem

doi:10.3174/ajnr.a1574

Cited by 13 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients in IV class according to the Harrington classification are candidates for this procedure. It is a relatively simple surgical technique, but instability or dislocation of a prosthesis may occur [ 11 , 12 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of metastatic lesions localized in the acetabulum

Guzik¹

2016

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundMetastatic lesions localized in the periacetabular area cause troublesome pain and reduced mobility of the patients. Radiotherapy effectively decreases pain, yet it does not restore the ability to load the joint. Surgical treatment involving resection of metastatic lesions and joint reconstruction using bone grafts is burdened with a high rate of complications. Modular tumor prostheses are being increasingly used. In some cases, it is possible to strengthen the acetabular roof with bone cement using vertebroplasty kits. The aim of the study was to demonstrate various methods of treatment of metastatic lesions localized in the periacetabular area together with the analysis of their results and effectiveness.MethodsBetween 2010 and 2015, 27 patients with cancer metastases to the acetabulum were treated at our department. Qualification for surgical treatment was multifaceted with numerous aspects being considered. They included patients’ general condition, type of neoplasm, clinical stage, and prognosis. CT and MRI scans of the pelvis were performed in each case. Before the surgery and 3 months following the surgery, visual analogue scale (VAS) pain intensity, Karnofsky functional status, and motor ability according to the Harris scale were evaluated. Bone cement (PMMA)-augmentation was performed in 21 patients, of whom nine had cement injected precutaneously and 12 at proximal femur resection alloplasty. Hemipelvectomy Type II combined with implantation of LUMiC resection prosthesis of the acetabulum were performed in six cases.ResultsThe quality of life improved in all the patients. After percutaneous cement injection, the mean pain intensity VAS score was 2.7, and the mean Karnofsky functional status score was 71.8. The mean postoperative Harris hip score (HHS) was 94 points. The patients who had undergone resection alloplasty on the proximal femur combined with periacetabular cement injection were walking using one crutch. In this group of patients, the mean postoperative pain intensity, functional status, and gait efficiency scores were 4.5, 65.7, and 82 points, respectively. The mean pain intensity VAS score in patients who had LUMiC prostheses implanted was 3.4. Their mean functional status score was 65 and the gait efficiency score 71 points. All the patients were able to walk on crutches.ConclusionsStrengthening of the acetabular roof with bone cement in a specific group of patients is an adequate method of treatment which decreases pain and allows for loading the affected limb while walking. Internal hemipelvectomy combined with LUMiC prosthesis implantation makes it possible for the patients to walk using crutches and significantly reduces pain.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The results were good. The mean preoperative VAS score was 8.6, while the mean postoperative VAS score was 3.8 [ 16 ]. Good treatment results were also accomplished by Hierholzer et al and Yong-il Kim et al [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of metastatic lesions localized in the acetabulum

Guzik¹

2016

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…A variety of open and minimally invasive surgical procedures have been used to treat these fractures with varied success 14–18 . These include internal fixation techniques, 14,16–18 partial or total sacrectomy, 15–17 and percutaneous sacroplasty 13,19 . As a minimally invasive technique, percutaneous sacroplasty is intended to alleviate pain and provide stabilization to a weakened sacral region 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Sacroplasty and Sacroiliac Joint Cementation under Fluoroscopic Guidance for Lower Back Pain Related to Sacral Metastatic Tumors with Sacroiliac Joint Invasion

Nebreda¹,

Vallejo²,

Aliaga³

et al. 2010

Pain Practice

View full text Add to dashboard Cite

Cancer patients with bone metastases are at risk of a variety of skeletal events, including vertebral compression and pathologic fractures. Approximately 30% to 40% of patients with advanced lung cancer will develop bone metastases in the course of their disease, resulting in a significant negative impact on both morbidity and survival. Skeletal complications of bone metastases include pain, pathologic fractures, spinal cord compression, and hypercalcemia. The spine is the most frequent site of skeletal metastases. We present a 48-year-old female with intractable and incapacitating low back pain because of metastatic bone tumor in the left lateral side of S1 and S2 with left sacroiliac invasion. Imaging identified a metastatic invasion of the sacrum. Percutaneous sacroplasty, a safe and effective procedure for sacral-insufficient fractures, was performed under fluoroscopy guidance. However, the expected pain relief was not achieved. At 1 month, the patient remained invalided by severe back pain, which was localized to the left sacroiliac joint. In a second procedure, the sacroiliac joint was cemented. Pain relief was complete, immediate, and sustained until the patient's death related to the underlying oncologic disease. No complications were observed. Few reports exist about the treatment of sacral metastatic tumors with percutaneous sacroplasty. Further, no previous reports about sacroiliac joint cementation for joint stabilization have been found. In the present case, sacroiliac joint cementation successfully resolved residual pain that remained despite percutaneous sacroplasty treatment of the pathologic sacral fracture.

show abstract

“…Esta última constituye una opción segura y efectiva como tratamiento mínimamente invasivo para el alivio del dolor y la estabilización de la zona sacra en régimen ambulatorio o con una mínima estancia hospitalaria (14,15).…”

Section: Epidemiologíaunclassified

Sacroplastia

Clavo¹,

Valls²,

Font³

et al. 2014

Rev. Soc. Esp. Dolor

View full text Add to dashboard Cite

INTRODUCCIÓNLas fracturas sacras se pueden presentar como consecuencia de traumatismo directo o asociadas a fuerzas de estrés continuadas sobre un hueso debilitado, bien sea por estadios osteoporóticos avanzados o posteriores a la radioterapia (fracturas de estrés o fracturas por insuficiencia). La sacroplastia percutánea realizada bajo guía radiológica -fluoroscopia (arco en C) o con tomografía computerizada (TC)-es un procedimiento mínimamente invasivo que mejora el dolor y estabiliza la zona sacra (1).En las distintas series la mejoría del dolor puede ser cercana a porcentajes del 90 % en pacientes con fracturas y 60 al 70 % en patologías de origen neoplásico (2). Los mecanismos responsables del alivio del proceso doloroso obtenido tras la realización de esta técnica surgen por la posible acción combinada de la ablación termal neural tras la inyección, la neurolisis química y por la estabilización, fijación de la fractura sacra. EPIDEMIOLOGÍASe estima que entre un 62 % a un 86 % de los pacientes con estados oncológicos avanzados presentan niveles elevados de dolor (3-7). Dentro de los procesos oncológicos, las metástasis son tan comunes como los tumores primarios y cuando se presentan lo hacen muy frecuentemente en sus formas osteolíticas con los conocidos perjuicios sobre los pacientes. Se relacionan principalmente con tumores de próstata, mama, pulmón y presentan importante riesgo de asociar situaciones como aplastamiento vertebral y fracturas patológicas. Entre las consecuencias más frecuentes de las metástasis óseas se encuentran el dolor, las fracturas patológicas, la compresión radicular y la hipercalcemia.La región sacra, con un 21 %, es el tercer emplazamiento más frecuente de las metástasis, tras las vértebras dorsales (32 %) y la articulación del hombro (28 %). Las fracturas del sacro se presentan generalmente asociadas a cuadros de intenso dolor, discapacidad y complicaciones neuroló-gicas (8).Como parte del arsenal terapéutico intervencionista de las mismas, disponemos de la posibilidad de realizar fijaciones (9,11-13), sacrectomía parcial (10-12) o total y la sacroplastia percutánea. Esta última constituye una opción segura y efectiva como tratamiento mínimamente invasivo para el alivio del dolor y la estabilización de la zona sacra en régimen ambulatorio o con una mínima estancia hospitalaria (14,15). INDICACIONESDolor intratable en región sacra con evidencia radiológi-ca por medio de TC, RM o gammagráfía de fracturas a este nivel, lesiones captantes -secundarias a tumores primarios o bien secundarias a tumores en otras localizaciones (mieloma, cáncer de mama, próstata, pulmón…)-o derivadas de fracturas osteoporóticas.

show abstract

Percutaneous Cement Augmentations of Malignant Lesions of the Sacrum and Pelvis: Fig 1.

Cited by 13 publications

References 15 publications

Treatment of metastatic lesions localized in the acetabulum

Treatment of metastatic lesions localized in the acetabulum

Percutaneous Sacroplasty and Sacroiliac Joint Cementation under Fluoroscopic Guidance for Lower Back Pain Related to Sacral Metastatic Tumors with Sacroiliac Joint Invasion

Sacroplastia

Contact Info

Product

Resources

About