Cement Plug Fragmentation Following Percutaneous Cementoplasty of the Bony Pelvis: Is it a Frequent Finding in Clinical Practice?

ABSTRACT

PURPOSE: To report the rate of fragmentation of the cement plug following percutaneous cementoplasty with polymethylmethacrylate (PMMA) in the bony pelvis (i.e., pelvic bones or sacrum). MATERIALS AND METHODS: Post-interventional and follow-up CT scans of 56 patients (36 men; mean age of 68.4 ± 15.4) with a total of 98 percutaneous cementoplasty procedures were analyzed. Indications for treatment included painful malignant tumors (42.9%; 42/98) and insufficiency fractures (57,1%; 56/98). Fragmentation of PMMA was recorded for each cement plug. RESULTS: Mean interval between the procedure and the last available CT scan was 29.3 ± 18.8 months. There was no significant difference between the length of follow-up of malignant lesions (27.6 ± 15.1 months) and insufficiency fractures (29 ± 20.5 months) (p = 0.69). Fragmentation was diagnosed following 2/98 (2%) procedures, both in the malignant lesions group. The time intervals between the procedure and the first visualization of cement fragmentation were 6 for the first and 24 months for the second patient. CONCLUSION: Fragmentation of the PMMA plug following percutaneous cementoplasty in the bony pelvis is a rare finding at midterm follow-up. It was only observed in cementoplasty performed in malignant lesions and seems to be more a consequence of local mechanical stresses than as a result of porosity.