Abstract

Purpose

To evaluate the feasibility, efficacy and safety of sternal percutaneous fixation by internal cemented screw (FICS) using fluoroscopy and/or CT needle guidance.

Materials and Methods

This retrospective single-center study analyzed 9 consecutive cancer patients managed with percutaneous FICS for sternal fracture fixation or osteolytic metastasis consolidation, from May 2014 to February 2019. Eastern Cooperative Oncology Group performance status, Numeric Pain Rating Scale (NPRS) and opioid use were studied preoperatively and postoperatively. Sternal images at last follow-up appointment were also collected.

Results

Among the 9 patients, 7 had a sternal fracture with 5 being displaced. The technical feasibility was 100%. Both NPRS score significantly decreased from 5.6/10 ± 2.8 to 1.1/10 ± 1.6, and analgesic consumption was significantly improved (p = 0.03) after intervention. No post-procedural complications requiring surgical correction or screw displacement occurred after a mean imaging follow-up that exceeded 1 year (mean follow-up duration, 401.8 days ± 305.8).

Conclusion

Image-guided sternal percutaneous FICS is feasible and safe. It reduces pain and analgesic consumption related to pathologic fracture of the sternum.

中文翻译：

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胸骨内固定螺钉经皮固定

摘要

目的

为了评估使用内窥镜和/或CT针头引导的内部骨水泥螺钉（FICS）进行胸骨经皮固定的可行性，有效性和安全性。

材料和方法

这项回顾性单中心研究分析了2014年5月至2019年2月经皮FICS经胸骨骨折固定或溶骨转移巩固治疗的9例连续癌症患者。研究了东部合作肿瘤小组的表现，数字疼痛评分量表（NPRS）和阿片类药物的使用术前和术后。最后一次随访时的胸骨图像也被收集。

结果

在9例患者中，有7例胸骨骨折，其中5例移位。技术可行性为100％。 干预后，两种NPRS评分均从5.6 / 10±2.8显着降低至1.1 / 10±1.6，并且止痛药的使用显着改善（p = 0.03）。平均影像学随访超过1年（平均随访时间401.8天±305.8）后，没有发生需要手术矫正或螺钉移位的手术后并发症。

结论

图像引导胸骨经皮FICS可行且安全。它减少了与胸骨病理性骨折有关的疼痛和止痛药的消耗。