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Cimentoplastie cotyle J.Palussière

02a9977d1d0662421ee64fc05f765281?s=47 journeevertebro
November 03, 2013
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Cimentoplastie cotyle J.Palussière

02a9977d1d0662421ee64fc05f765281?s=128

journeevertebro

November 03, 2013
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  1. Cimentoplastie cotyle J. Palussière Institut Bergonié Bordeaux 10 Février 2012

  2. ACETABULUM Lytic tumoral invasion of the acetabulum is frequent causing

    : pathologic fractures pain disability Percutaneous cementoplasty since 1995 A.Cotten Radiology
  3. ACETABULUM : When the weight-bearing part is involved Extent of

    dome Column involvement 3D reconstruction CT+++ to assess location/extent of the lytic process presence of cortical destruction or fracture presence of soft tissue involvement
  4. How? under CT control fluoroscopy guided combining the 2 modalities

    general anesthesia local anesthesia + sedation
  5. Is a cortical lysis a CI?

  6. Is a cortical lysis a CI?

  7. Is a cortical lysis a CI?

  8. Is a cortical lysis a CI?

  9. CT before and after

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  19. Sup and inf pubic rami To fill progressively in different

    sessions
  20. Sup and Inf pubic rami : A good knowledge of

    pelvic anatomic noble structures (art and nerves) is mandatory Under Fluoroscopic guidance A Kelekis JVIR 2005
  21. Blastic?

  22. Complications Leakage into the hip joint - to stop cement

    injection - to passively move the lower limb to shape the cement into the joint But a rapid chondrolysis after an intra-articular leak of bone cement LeclairA Gangi A Skeletal radiol. 2000 May Pulmonary embolism leakage into the pelvic veins (gluteal)
  23. Results Pain Improvement in walking A. Cotten Radiology 1995 11

    patients 9/11 pain relief , walking improved in each PY Marcy Support Care cancer 2000 18 patients Improvement in pain and walking 81,8% except 1 patient acetabular fracture Fracture long term follow up
  24. G Anselmetti CVIR 2008 50 patients (19 pelvic bone) Pain

    was not improved in 6% of the patients
  25. Woman 52 y uterine cancer acetabular metastasis treated with radiotherapy

  26. Short procedure, few secondary effects : less pain and discomfort,

    reduced recovery time, short hospital stay-all, Acetabulum : Complete filling during multiple sessions ! ! ! To take care to ant. and post. Column