Metastases cementoplasty

Percutaneous cementoplasty (PC) consists of injecting acrylic cement (polymethylmethacrylate) in bone and is a perfect example of a minimally invasive technique in the musculoskeletal system. PC has been performed since 1984. Its role is to consolidate weight-bearing bone and to treat pain. Bone packing with acrylic cement is a procedure aimed at preventing pathological fractures and pain in patients with vertebral body lesions and acetabular metastasis. 

Fig. 10.4a,b. Acetabular cementoplasty. a A 14-gauge needle is positioned in the metastasis and the cement is injected under fluoroscopy control. Between 2 and 8 ml of acrylic cement are injected depending on tumor size, b CT control after the procedure. After treatment, the patient was able to stand and walk without assistance... 

Fig. 10.5a-c. Cementoplasty of the femoral head, a Painful metastasis of the femoral head in an advanced stage of lung cancer. This particular patient refused surgery, b A 15-gauge needle is positioned in the center of the metastasis, c Injection of 4 ml of cement. Rapid pain relief was achieved... 

In one case, an asymptomatic intercostal artery injection occurred during vertebroplasty of a hyper-vascularized breast cancer metastasis. Thus, hyper-vascularized lesions should be evaluated by phle-bogram in anteroposterior and lateral views prior to cementoplasty, particularly in the dorsolumbar region (Tll-Ll). 

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