Kelekis A, Filippiadis D, Anselmetti G, Brountzos E, Mavrogenis A, Papagelopoulos P, Kelekis N, Martin J-B
2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece.
GVM Care and Research Maria Pia Hospital, Strada Comunale di Mongreno 180, 10132, Turin, Italy.
Cardiovasc Intervent Radiol. 2016 Jan;39(1):90-6. doi: 10.1007/s00270-015-1138-8. Epub 2015 Jun 6.
To evaluate clinical efficacy/safety of augmented peripheral osteoplasty in oncologic patients with long-term follow-up.
Percutaneous augmented peripheral osteoplasty was performed in 12 patients suffering from symptomatic lesions of long bones. Under extensive local sterility measures, anesthesiology care, and fluoroscopic guidance, direct access to lesion was obtained and coaxially a metallic mesh consisting of 25-50 medical grade stainless steel micro-needles (22 G, 2-6 cm length) was inserted. PMMA for vertebroplasty was finally injected under fluoroscopic control. CT assessed implant position 24-h post-treatment.
Clinical evaluation included immediate and delayed follow-up studies of patient's general condition, NVS pain score, and neurological status. Imaging assessed implant's long-term stability. Mean follow-up was 16.17 ± 10.93 months (range 2-36 months). Comparing patients' scores prior (8.33 ± 1.67 NVS units) and post (1.42 ± 1.62 NVS units) augmented peripheral osteoplasty, there was a mean decrease of 6.92 ± 1.51 NVS units. Overall mobility improved in 12/12 patients. No complication was observed.
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.
通过长期随访评估增强型外周骨成形术在肿瘤患者中的临床疗效/安全性。
对12例长骨有症状性病变的患者进行经皮增强型外周骨成形术。在广泛的局部无菌措施、麻醉护理和透视引导下，直接进入病变部位，并同轴插入一个由25 - 50根医用级不锈钢微针（22G，长2 - 6厘米）组成的金属网。最后在透视控制下注入用于椎体成形术的聚甲基丙烯酸甲酯（PMMA）。术后24小时通过CT评估植入物位置。
临床评估包括对患者一般状况、数字疼痛评分（NVS）和神经状态的即时及延迟随访研究。影像学评估植入物的长期稳定性。平均随访时间为16.17 ± 10.93个月（范围2 - 36个月）。比较患者在增强型外周骨成形术前（8.33 ± 1.67 NVS单位）和术后（1.42 ± 1.62 NVS单位）的评分，平均降低了6.92 ± 1.51 NVS单位。12例患者的整体活动能力均有所改善。未观察到并发症。
经皮增强型外周骨成形术（钢筋概念）用于长骨有症状的恶性病变似乎是一种可能的骨稳定新技术。这种联合似乎能提供必要的稳定性，以抵抗长骨在负重过程中所受的剪切力。
