Biomechanics of the Osseous Pelvis and Its Implication for Consolidative Treatments in Interventional Oncology
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REVIEW
NON-VASCULAR INTERVENTIONS
Biomechanics of the Osseous Pelvis and Its Implication for Consolidative Treatments in Interventional Oncology Julien Garnon1,2 • Jack W. Jennings3 • Laurence Meylheuc2 • Pierre Auloge1 Julia Weiss1 • Guillaume Koch1 • Jean Caudrelier1 • Roberto Luigi Cazzato1 • Bernard Bayle2 • Afshin Gangi1
•
Received: 15 May 2020 / Accepted: 5 August 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract The osseous pelvis is a frequent site of metastases. Alteration of bone integrity may lead to pain but also to functional disability and pathological fractures. Percutaneous image-guided minimally invasive procedures, such as cementoplasty and screw fixation, have emerged as a viable option to provide bone reinforcement and fracture fixation, as stand-alone or combined techniques. Understanding the biomechanics of the osseous pelvis is paramount to tailor the treatment to the clinical situation. The purpose of the present review is to present the biomechanics of the osseous pelvis and discuss its implication for the choice of the optimal consolidative treatment. Keywords Osseous pelvis Pelvic bone Sacrum Biomechanics Cementoplasty Percutaneous screw fixation
Introduction The pelvis is the second most frequent site of osseous metastases after the spine [1]. Alteration of bone integrity in the pelvic girdle may not only lead to pain but also to functional disability and pathological fractures, which in turn can greatly impair the patient’s quality of life [2]. Moreover, confinement to bed rest seriously exposes the patient to medical complications, such as thromboembolic and infectious adverse events. External beam radiation and stereotactic body radiation therapy are effective tools to alleviate the pain; however, they do not address the mechanical instability [3, 4]. A wide range of open surgical procedures have been developed to manage fractures and impending fractures of the pelvic girdle, mostly involving the acetabulum and the proximal femur [5, 6]. However, the ability to perform these potentially complex procedures depends on the general condition of the patient, as the morbidity is not negligible [7]. Image-guided percutaneous
& Julien Garnon [email protected]
Roberto Luigi Cazzato [email protected]
Jack W. Jennings [email protected]
Bernard Bayle [email protected]
Laurence Meylheuc [email protected]
Afshin Gangi [email protected]
Pierre Auloge [email protected]
1
Julia Weiss [email protected]
Department of Interventional Radiology, Nouvel Hoˆpital Civil, 1, place de l’hoˆpital, 67096 Strasbourg Cedex, France
2
Guillaume Koch [email protected]
UMR 7357, CNRS, ICube, INSA Strasbourg, Universite´ de Strasbourg, 67091 Strasbourg, France
3
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Mo, USA
Jean Caudrelier [email protected]
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