• Roberto Luigi Cazzato, Xavier Buy, Omer Eker, Thierry Fabre, and Jean Palussiere.
• Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France, r.cazzato@unicampus.it.
• Eur Radiol. 2014 Dec 1;24(12):3059-68.

ObjectiveTo review our 10-year experience with percutaneous long bone cementoplasty (PLBC) in poor surgical patients.Materials And MethodsFifty-one patients were included. Primary endpoints were pain and functional outcomes one month following PLBC. A secondary endpoint dealt with factors predicting cement leakage. Delayed adverse events and overall survival (OS) were also investigated.ResultsSixty-six lesions were treated. Local pain relief at 1-month occurred in 59/66 lesions (89.4%); pain improvement was significantly more common for lesions of the upper limb (p < 0.05). Limb functionality at one month improved in 46/64 lesions (71.8%); lesions ≤ 3 cm showed better outcomes in terms of limb function (p <0.05). Cement leakage was minor and asymptomatic in 26 cases (26/66, 39.4 %); in one case (1/66, 1.5%) symptomatic minor amount of intra-articular cement leakage occurred. Factors predicting cement leakage were diaphyseal location of the lesions, cortical bone disruption and extra-bone tumour extension (p < 0.05). The most common delayed adverse event was fracture (6/66, 9.1%). OS at 1-, 2- and 3-years was 61.2%, 30.9% and 23.0%, respectively.ConclusionsFor poor surgical candidates, at 1-month follow-up, PLBC proved to be safe and effective. If stress fracture occurs following PLBC, surgical external fixation is still an affordable therapeutic option.Key PointsPercutaneous long bone cementoplasty may be proposed to poor surgical patients. Pain palliation is more significant for lesions of the upper limb. Limb function improves significantly for lesions sized ≤ 3 cm. Fracture is the most common delayed adverse event (9% of cases). If cement stress fracture occurs, surgical external fixation is still feasible.

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