Percutaneous consolidation of bone metastases: strategies and techniques

Abstract

Patients with cancer can present with bone metastases (BM), which are frequently complicated by different types of fractures necessitating prompt management to avoid serious impairment in terms of quality of life and survival.Percutaneous image-guided bone consolidation has rapidly emerged as an alternative to surgical fixation and is mainly reserved for patients who are deemed unfit for surgical management. Two percutaneous techniques, osteoplasty and osteosynthesis, are available and are selected based on the biomechanics of the target bones as well as the fracture types.The aim of this narrative review is to present the different types of BM-related fractures and the interventional strategies and techniques underpinning their minimally invasive percutaneous fixation.

Clinical significance of expression level of CX3CL1–CX3CR1 axis in bone metastasis of lung cancer

“…As the incidence of bone metastasis in lung cancer is relatively elusive, there is a lack of effective early detection methods, thus it is easy to miss the best expectations, and patients often have different degrees of metastasis when diagnosed. Therefore, early identi cation and detection of bone metastasis from lung cancer can help early treatment, improving the quality of patients' life [3,4]. At present, conventional testing methods cannot detect bone metastasis from cancer in time, and some sensitive tests have defects such as radiation damage, cumbersome operation, and high cost.…”

Percutaneous image-guided thermal ablation of bone metastases: a retrospective propensity study comparing the safety profile of radio-frequency ablation and cryo-ablation

“…Coming to the analysis of the type of complications encountered in our study, pathological fracture was the most common major complication occurring in the CA group, with fractures occurring (in two acetabulae, one iliac bone and one scapula) approximately 2 months after the treatment, and requiring percutaneous fixation. This is recognized following bone tumor TA and results from loss of structural and mechanical integrity of the bone due to tumor and post-TA necrosis, which necessitates immediate bone consolidation during the same interventional session of TA to prevent such sequela [13][14][15]17]. This represents a major advantage of percutaneous TA when compared to RT [13,14,22], which is also affected from a non-negligible risk of secondary fracture particularly when stereotactic techniques are used.…”

“…This represents a major advantage of percutaneous TA when compared to RT [13,14,22], which is also affected from a non-negligible risk of secondary fracture particularly when stereotactic techniques are used. Indications to perform bone consolidation should be based on Mirel's score for long bone, SINS score for spine and should also take into account the size of the target tumor and the cortical involvement [17,23,24]. Cementoplasty is the most adapted consolidation technique for bones mainly undergoing compressive stresses (e.g., vertebral body).…”

French Multidisciplinary Approach for the Treatment of MSK Tumors

“…Osteoplasty and osteosynthesis are applied according to standard and relatively simple biomechanics. 4,91 In general, osteoplasty is highly resistant to compressive stresses, and it is therefore applied in vertebral bodies, sacral wings, acetabula, and to fill small lytic lesions of the epiphyseal area in long bones. 4 In contrast, osteosynthesis is applied to treat non-or Fig.…”