Interventional Spine

Bassem A Georgy, MD
Wade Wong, DO, FACR, ASSR Member

Scientific Paper

Purpose

To evaluate the feasibility, effectiveness, safety and clinical outcome for percutaneous cement augmentation of patients with lytic lesions in the sacrum and ileum

Methods & Materials

Prospective study of 8 patients, 4 males and 4 females, with a median age of 74 years was performed. Patients had different types of benign and malignant metastatic lytic lesions. Informed consent was obtained according to our Institutional protocol. All patients underwent Pre procedure CT and MR except one patient. All patients had a post procedure CT. A biopsy was performed in all cases before cement augmentation. All patients had sacral lesions. Four patients had a second lesion in the ileum. All cases were done under CT guidance except one case done under fluoroscopy guidance. In four patients, more than one needle was used.

Results

Adequate cement deposition was seen in all cases except one. Two patients had minimal clinically insignificant extravasations. All treated patients reported decreased pain level using visual analog pain scale except two cases within 2-4 weeks follow up (75%). No other subsequent surgical interventions were required, to our knowledge, to maintain improvement in any case.

Conclusion

Percutaneous cement augmentation of lytic lesions of the sacrum and ileum is a feasible and safe technique that can be performed under CT or fluoroscopy guidance. The technique results in decrease pain levels and allow patients to tolerate future treatment.

References

Consultant; Kyphon Inc
Speaker; kyphon Inc, Arthrocare Inc, Cardinal Inc, Disc-o-tech