Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture

Abstract

Objective: To compare the efficacy of percutaneous long bone cementoplasty (PLBC) with and without embedding a cement-filled catheter in the medullary canal (ECFC) for painful long bone metastases with impending fracture.

Methods: A retrospective study was conducted in 36 consecutive patients undergoing PLBC and ECFC combination (n = 17, group A) or PLBC alone (n = 19, group B). All patients had a high risk of impending fracture in the long bone based on Mirels' scoring system. Clinical effects were evaluated using both a pre- and a postoperative visual analogue scale (VAS) and Karnofsky performance scale (KPS).

Results: Overall pain relief rate with excellent (VAS 0-2) and good (VAS 2.5-4.5) results during follow-up was significantly higher in group A than in group B (88.2 % vs. 57.9 %, P<0.05). The average VAS and KPS changes in group A were significantly higher than those in group B at 1, 3 and 6 months postoperatively (P<0.05). Also, the rate of fractures of the treated long bone in group A was significantly lower than that in group B (P<0.05).

Conclusions: Combined PLBC and ECFC is a safe and effective procedure for long bone metastases with impending fracture.

Key points: • Metastases in long bones may cause pain and subsequent pathological fractures. • Cementoplasty resulted in significant pain relief in patients with long bone metastases. • Combination of PLBC and ECFC may reduce the incidence of fractures.

Keywords: Cementoplasty; Interventional internal fixation; Long bone; Pain; Pathological fracture.