J Korean Med Sci.  2018 Feb;33(8):e61. 10.3346/jkms.2018.33.e61.

Extraspinal Percutaneous Osteoplasty for the Treatment of Painful Bony Metastasis

• Lee JH
• Kim SY
• Ok HG
• Kim TK
• Kim KH

• KMID: 2403317
• DOI: http://doi.org/10.3346/jkms.2018.33.e61

Abstract

BACKGROUND
Extraspinal percutaneous osteoplasties (POPs) are novel techniques for the treatment of painful bony metastasis, which is often the cause of both persistent and incidental breakthrough pain. This retrospective study explored the efficacy and complications of extraspinal POPs.
METHODS
The origin of the cancer metastasis, performed POP sites, necessity of adjacent joint injections, pain and Karnofsky Performance Scale (KPS) scores, complications related to the POPs, and life expectancy were evaluated from the medical records from 2009 to 2016.
RESULTS
A total of 47 (M/F = 28/19) patients had received 54 POPs, including costoplasty, scapuloplasty, ilioplasty, humeroplasty, ischioplasty, femoroplasty, sternoplasty, and puboplasty, in order of frequency. The most common sites for the origin of the cancer, in order of frequency, were the lung, liver, breast, colon, and kidney. All patients receiving POPs including scapuloplasty, ilioplasty, humeroplasty, and femoroplasty needed adjacent joint injections before or after the POPs. Pain due to metastatic lesions was reduced significantly immediately after the POPs and the reduction was sustained until the end of their lives. The median KPS was increased from 35.4% to 67.7% immediately after the POPs. There were no complications related to the procedures. The mean life expectancy after performing the POPs, for 35 patients which died afterwards, was 99.3 days, ranging from 1 to 767 days.
CONCLUSION
Even though pain in the isolated POP sites may be difficult to measure due to overlapping systemic pain, the POPs provided immediate local pain relief, and the patients showed better physical performance without procedure-related complications.

Keyword

Bone; Early Mobilization; Karnofsky Performance Status Scale; Life Expectancy; Metastasis; Percutaneous Osteoplasty

MeSH Terms

Breakthrough Pain
Breast
Cementoplasty*
Colon
Early Ambulation
Humans
Joints
Karnofsky Performance Status
Kidney
Life Expectancy
Liver
Lung
Medical Records
Neoplasm Metastasis*
Retrospective Studies