Cement Plug Fragmentation Following Percutaneous Cementoplasty of the Bony Pelvis: Is it a Frequent Finding in Clinical Practice?

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)...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2021-03, Vol.44 (3), p.421-427
Main Authors: Garnon, Julien, Meylheuc, Laurence, De Marini, Pierre, Koch, Guillaume, Cazzato, Roberto Luigi, Bayle, Bernard, Gangi, Afshin
Format: Article
Language:English
Subjects:
Automatic
Cardiology
Cement
Clinical Investigation
Computed tomography
Engineering Sciences
Fractures
Fragmentation
Imaging
Lesions
Medicine
Medicine & Public Health
Non-Vascular Interventions
Nuclear Medicine
Patients
Pelvis
Polymethylmethacrylate
Porosity
Radiology
Sacrum
Tumors
Ultrasound
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Summary: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 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.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-020-02715-y