Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.
Skeletal Radiol. 2019 Sep;48(9):1345-1355. doi: 10.1007/s00256-019-3156-0. Epub 2019 Feb 2.
To evaluate lesion filling and other factors that could affect the clinical outcomes of cementoplasty for pelvic bone metastases.
We retrospectively reviewed the files of 40 patients treated for 44 pelvic bone metastases, collected the parameters related to patients (pain relief evaluated on a visual analog scale, subsequent fractures, and need for surgery), lesions (size, cortical breach score, fracture, soft-tissue extension), and cementoplasty procedures (number of needles, volume of cement, percentage of lesion filling, cement leaks, residual acetabular roof defect), and performed a statistical analysis.
The lesions were on average 43.2 mm in diameter and the mean cortical breach score was 2.5 out of 6, with a pathological fracture in 14 lesions. The number of needles inserted was one in 32 out of 44, two in 10 out of 44, and three in 2 out of 44. On average, the volume of cement injected per lesion was 10.3 ml and the filling was 54.8%. Mild or moderate asymptomatic cement leakage occurred in 20 lesions (45.5%). The mean pain score was 84.2 mm before the procedure (with no correlation with lesion size, cortical breach score or fracture) and 45.6 mm at follow-up. The pain relief of 38.6 mm was statistically significant (p < 0.001) and did not correlate with the filling percentage. There were no fractures of the treated lesions at a mean follow-up of 355 days.
Cementoplasty of pelvic bone metastases appears effective for providing pain relief and may prevent subsequent fractures. We were unable to demonstrate a correlation between the lesion filling and the degree of pain relief.
评估骨水泥成形术治疗骨盆骨转移瘤的病灶填充情况及其他影响临床效果的因素。
我们回顾性分析了 40 例 44 处骨盆骨转移瘤患者的病历资料，收集了与患者（疼痛视觉模拟评分评估的缓解程度、随后发生的骨折和手术需求）、病变（大小、皮质破坏评分、骨折、软组织延伸）和骨水泥成形术程序（针数、骨水泥量、病灶填充百分比、骨水泥渗漏、残余髋臼顶缺损）相关的参数，并进行了统计学分析。
病灶平均直径为 43.2mm，皮质破坏评分平均为 6 分中的 2.5 分，14 处病灶发生病理性骨折。44 处病灶中，32 处插入 1 根针，10 处插入 2 根针，2 处插入 3 根针。平均每处病灶注射的骨水泥量为 10.3ml，填充率为 54.8%。20 处（45.5%）出现轻度或中度无症状骨水泥渗漏。术前平均疼痛评分为 84.2mm（与病灶大小、皮质破坏评分或骨折无相关性），随访时为 45.6mm。38.6mm 的疼痛缓解具有统计学意义（p<0.001），与填充百分比无关。在平均 355 天的随访中，治疗的病灶无骨折发生。
骨水泥成形术治疗骨盆骨转移瘤可有效缓解疼痛，并可能预防随后发生的骨折。我们未能证明病灶填充与疼痛缓解程度之间存在相关性。
