Cement Plug Fragmentation Following Percutaneous Cementoplasty of the Bony Pelvis: Is it a Frequent Finding in Clinical
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CLINICAL INVESTIGATION
NON-VASCULAR INTERVENTIONS
Cement Plug Fragmentation Following Percutaneous Cementoplasty of the Bony Pelvis: Is it a Frequent Finding in Clinical Practice? Julien Garnon1,2 • Laurence Meylheuc2 • Pierre De Marini1 • Guillaume Koch1 Roberto Luigi Cazzato1 • Bernard Bayle2 • Afshin Gangi1
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Received: 12 July 2020 / Accepted: 12 November 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To report the rate of fragmentation of the cement plug following percutaneous cementoplasty with polymethylmethacrylate (PMMA) in the bony pelvis (i.e., pelvic bones or sacrum). Materials and Methods Post-interventional and follow-up CT scans of 56 patients (36 men; mean age of 68.4 ± 15.4) with a total of 98 percutaneous cementoplasty procedures were analyzed. Indications for treatment included painful malignant tumors (42.9%; 42/98) and insufficiency fractures (57,1%; 56/98). Fragmentation of PMMA was recorded for each cement plug. Results Mean interval between the procedure and the last available CT scan was 29.3 ± 18.8 months. There was no
& Julien Garnon [email protected]
significant difference between the length of follow-up of malignant lesions (27.6 ± 15.1 months) and insufficiency fractures (29 ± 20.5 months) (p = 0.69). Fragmentation was diagnosed following 2/98 (2%) procedures, both in the malignant lesions group. The time intervals between the procedure and the first visualization of cement fragmentation were 6 for the first and 24 months for the second patient. Conclusion Fragmentation of the PMMA plug following percutaneous cementoplasty in the bony pelvis is a rare finding at midterm follow-up. It was only observed in cementoplasty performed in malignant lesions and seems to be more a consequence of local mechanical stresses than as a result of porosity. Keywords Cementoplasty PMMA Fragmentation Breakage Bony pelvis
Laurence Meylheuc [email protected] Pierre De Marini [email protected]
Introduction
Guillaume Koch [email protected]
Percutaneous cementoplasty with polymethylmetacrylate (PMMA) bone cement is an effective treatment for painful spinal or extraspinal bone metastases and spinal osteoporotic compression fractures [1–3]. Because of the mechanical properties of PMMA, cementoplasty also has the ability to achieve consolidation of fractures and impending fractures in locations predominantly withstanding compression stresses [4–6]. In the bony pelvis notably, cementoplasty has been indicated to stabilize insufficiency/pathological fractures of the sacral ala and impending fractures of the acetabulum [2, 5, 7, 8]. Once the cement has been deposited and has cured inside the bone,
Roberto Luigi Cazzato [email protected] Bernard Bayle [email protected] Afshin Gangi [email protected] 1
Department of Interventional Radiology, Nouvel Hoˆpital Civil, 1, place de l’hoˆpital, 67096 Strasbourg Cedex,
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