CT-guided bone cement infusion for metastatic tumor to the ilium

doi:10.3969/j.issn.2095-4344.2017.27.020

Abstract

Abstract:

BACKGROUND: Iliac bones are common habitant parts in metastatic tumor of bone, and the affiliate cortex is easy to be penetrated into soft tissue blots. The irregular iliac shape and its complex surrounding tissues create

the difficulties in puncture operations and cement perfusion.

OBJECTIVE: To investigate the clinical outcomes of CT-guided versus DSA-guided puncture combined with bone cement perfusion for metastatic tumor to the ilium.

METHODS: Sixty-four patients with metastatic tumor to the ilium udergoing bone cement perfusion were enrolled, and then divided into control and experimental groups (n=32 per group), followed by treated with DSA-guided percutaneous injection of bone cement, and CT-guided puncture, respectively. Subsequently, the diffuse distribution of bone cement was observed using CT. The success rate, leakage rate, Visual Analogue Scale scores and Oswestry Disability Index were compared between two groups.

RESULTS AND CONCLUSION: (1) All patients received the surgery successfully, and bone cement leakage happened in two cases of control group and one case of experimental group. (1) The Visual Analog Scale and Oswestry Disability Index scores in the two groups were significantly better than those before treatment (P < 0.05), and the scores showed no significant differences between two groups (P > 0.05). (3) No difference was found in the pain relief and functional recovery between two groups. (4) To conclude, CT-guided treatment can achieve satisfactory outcomes for metastatic tumor to the ilium by bone cement infusion in appropriate time.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Ilium, Polymethacrylic Acids, Tissue Engineering

CLC Number:

R318

Song Peng-wei, Yu Yang, Liu Ming-zhen, Liu Xun-wei, Wang Zhi-guo, Xie Zhi-yong. CT-guided bone cement infusion for metastatic tumor to the ilium [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(27): 4379-4384.

Figures/Tables 3

References

[1] Edwards BJ, Sun M, West DP, et al. Incidence of Atypical Femur Fractures in Cancer Patients: The MD Anderson Cancer Center Experience.J Bone Miner Res. 2016;31(8): 1569-1576.

[2] Baek SJ, Hur H, Min BS, et al. The Characteristics of Bone Metastasis in Patients with Colorectal Cancer: A Long-Term Report from a Single Institution.World J Surg. 2016;40(4): 982-986.

[3] Kim W, Han I, Jae HJ, et al. Preoperative embolization for bone metastasis from hepatocellular carcinoma. Orthopedics. 2015;38(2):e99-e105.

[4] 陈晓钟,张鸿未.骨转移瘤的临床研究进展[J].中国肿瘤,2006, 15(03):183-186.

[5] Conroy T, Malissard L, Dartois D, et al. Natural history and development of bone metastasis. Apropos of 429 cases. Bull Cancer.1988;75(9):845-857.

[6] Galibert P, Deramond H, Rosat P, et al.Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty.Neurochirurgie. 1987;33(2):166-168.

[7] Cotten A, Duquesnoy B. Percutaneous cementoplasty for malignant osteolysis of the acetabulum. Presse Med.1995; 24(28):1308-1310.

[8] 孙钢,金鹏,易玉海,等. 经皮注射聚甲基异丁烯酸治疗溶骨性骨盆区与外周骨转移瘤[J]. 中华放射学杂志, 2005,39(8): 869-873.

[9] Sun G, Jin P, Li M, et al. Percutaneous cementoplasty for painful osteolytic humeral metastases: initial experience with an innovative technique. Skeletal Radiology.2011;40(10): 1345-1348.

[10] Sun G, Jin P, Liu XW, et al. Cementoplasty for managing painful bone metastases outside the spine. European Radiology. 2014;24(3):731-737.

[11] Trumm CG,Pahl A,Helmberger TK,et al.CT fluoroscopy-guided percutaneous vertebroplasty in spinal malignancy: technical results, PMMA leakages, and complications in 202 patients. Skeletal Radiol. 2012;41(11): 1391-1400.

[12] Wang Z, Zhen Y, Wu C,et al. CT fluoroscopy-guided percutaneous osteoplasty for the treatment of osteolytic lung cancer bone metastases to the spine and pelvis. J Vasc Interv Radiol.2012;23(9):1135-1142.

[13] 李泉旺,胡凯文,姜敏,等.CT引导经皮穿刺骨成形术在恶性肿瘤骨破坏中的应用[J].临床肿瘤杂志,2010,8(15):745-748.

[14] 汪建华,邵成伟,左长京,等.CT引导下经皮骨成形术治疗骨转移瘤的临床应用[J].中国医疗器械信息,2008,14(6):4-7.

[15] Huskisson EC. Measurement of pain.Lancet. 1974;2(7889): 1127-1131.

[16] Fairbank JC, Couper J, Davies JB,et al. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980; 66(8):271-273.

[17] 廖正银,游昕,蒲吉.经皮骨成形术治疗肿瘤骨转移瘤[J].中国疼痛医学杂志,2011,17(12):714-718.

[18] Puget J, Utheza G. Reconstruction of the iliac bone using the homolateral femur after resection for pelvic tumor. Orthop Traumatol Surg Res.2014;100(1):43-47.

[19] Tillman RM,Myers GJ,Abudu AT,et al.The three-pin modified 'Harrington' procedure for advanced metastatic destruction of the acetabulum. J Bone Joint Surg Br.2008;90(1):84-87.

[20] Fuchs B,Hoekzema N,Larson DR,et al.Osteosarcoma of the pelvis: outcome analysis of surgical treatment. Clin Orthop Relat Res.2009;467(2):510-518.

[21] 郭征,王臻,李明全,等.髂骨恶性骨肿瘤切除后骨盆稳定性重建[J].中国修复重建外科杂志,2005,19(12):965-970.

[22] 胡永成,郑得志,徐宝山.高速磨钻在侵袭性骨肿瘤治疗中的应用[J].中国矫形外科杂志.2004,12(17):1309-1311.

[23] Matcuk GR Jr, Mahanty SR, Skalski MR, et al. Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.Emerg Radiol 2016;23(4): 365-375.

[24] Uezono H,Tsujino K,Moriki K,et al.Pelvic insufficiency fracture after definitive radiotherapy for uterine cervical cancer: retrospective analysis of risk factors.J Radiat Res. 2013; 54(6):1102-1109.

[25] Chow R, Hoskin P, Hollenberg D,et al. Efficacy of single fraction conventional radiation therapy for painful uncomplicated bone metastases: a systematic review and meta-analysis. Ann Palliat Med. 2017;6(2):125-142.

[26] Hashmi A, Guckenberger M, Kersh R, et al. Re-irradiation stereotactic body radiotherapy for spinal metastases: a multi-institutional outcome analysis. J Neurosurg Spine. 2016; 25(5):646-653.

[27] Ito T, Bilusic M, Chen D. Targeted radionuclides for prostate cancer bone metastases. Urol Oncol. 2015;33(1):2-6.

[28] Hillegonds DJ, Franklin S, Shelton DK, et al. The management of painful bone metastases with an emphasis on radionuclide therapy. J Natl Med Assoc. 2007;99(7):785-794.

[29] Dewar JA. Managing metastatic bone pain. BMJ. 2004; 329(7470):812-813.

[30] Chan S, Rowbottom L, McDonald R, et al. Pelvic insufficiency fractures in women following radiation treatment: a case series. Ann Palliat Med. 2016;5(3):233-237.

[31] Elliott SP,Jarosek SL,Alanee SR, et al.Three-dimensional external beam radiotherapy for prostate cancer increases the risk of hip fracture. Cancer. 2011;117(19):4557-4565.

[32] Prieto-Alhambra D, Avilés FF, Judge A, et al. Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality. Osteoporos Int. 2012;23(12): 2797-2803.

[33] . Moussazadeh N,Laufer I,Werner T,et al.Sacroplasty for cancer-associated insufficiency fractures. Neurosurgery. 2015;76(4):446-450.

[34] Liu XW, Jin P, Liu K,et al. Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture. Eur Radiol. 2017;27(1):120-127.

[35] 孙钢,丛永健,谢宗贵,等. 国产药械行经皮椎体成形术治疗椎体转移瘤[J].中国矫形外科杂志.2003,11(13):878-881.

[36] 孙钢,张殿星.经皮椎体成形术规范化条例[J].介入放射学杂志, 2004,13(01):90-91.

[37] 张辉,高中玉,徐财元,等.骨质疏松性椎体压缩骨折椎体成形：漏诊、重度椎体压缩、骨水泥渗漏及再发骨折225例分析[J].中国组织工程研究,2016,20(35):5256-5262.

[38] 吴海鸰,洪正华,洪华兴,等.CT引导下经皮穿刺椎体后凸成形术治疗骨质疏松性椎体压缩性骨折[J].医学影像学杂志, 2012, 22(1):115-118.

[39] Kim YJ, Lee JW, Kim KJ, et al. Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors. Skeletal Radiol.2010;39(8):757-766.

[40] Amar AP, Larsen DW, Teitelbaum GP. Percutaneous spinal interventions. Neurosurg Clin N Am. 2005;16(3):561-568.

[41] 吴春根,王卫国,程永德,等.DSA引导下经皮髋臼成形术治疗髋臼转移性肿瘤的临床研究[J].介入放射学杂志, 2009,18(12): 911-915.

[42] 吴云刚,石志才,张晔等.骨水泥强化椎体提高椎弓根螺钉置入后的稳定性[J].中国组织工程研究与临床康复,2010,14(42): 7951-7954.

[43] Sun G, Jin P, Liu X-w, et al. Cementoplasty for managing painful bone metastases outside the spine. European Radiology. 2014;24(3):731-737.