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SIR 2025

Interventional Oncology

Scientific Session

Session: Interventional Oncology 3

Sternal Screw Fixation and Cement Augmentation for Mechanical Stability of Pathologic Fractures

Tuesday, April 1, 2025
4:12 PM – 4:21 PM CT
Location: Music City Center, 207 AB
Purpose: To review our initial experience with image-guided percutaneous screw fixation and cement augmentation for stabilization of pathological fractures of the sternum. 

Materials and Methods: This is a retrospective single-center study. From April 2021 to August 2024, we analyzed 8 cancer patients (mean age 52 years; range 28-72) with symptomatic pathological fractures of the sternum unsuitable for surgery. One patient had fracture of the manubrium and the body of the sternum and underwent two separate percutaneous procedures at different times. Another patient had a fracture of the sternum and underwent two separate percutaneous procedures at different times due to inadequate pain control after the first procedure. Three patients had prior radiation therapy to the sternum with not enough pain alleviation. The patients were managed with percutaneous screw fixation and cementoplasty of the sternal fracture. Cannulated cemented screws and PMMA cement were placed under CT and fluoroscopic guidance. Thermal ablation was added in 5 patients for tumor control. Pre and post procedure p</span>ain score (Numeric Pain Rating Scale, NPRS) and adverse events were studied collected. Statistical test: Paired t-test 

Results: Technical success was achieved in all cases (100%), with no postprocedural complications. NPRS scores significantly decreased pre and post percutaneous screw fixation: mean 8.38 (SD:1.51) and 1.38 (SD:1.06) respectively (p< 0.001). The procedure decreased the pain scores by 7.0 points (95%CI: 5.71-8.86). Mean follow-up 170 days (range 23-763 days).  

Conclusion: Percutaneous cement augmentation both with and without screw fixation of pathological fractures of the sternum appears to be technically feasible with good safety profile. These procedures are efficacious in alleviating pain due to pathologic fractures of the sternum.