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.
Keywords: Bone metastasis; Cementoplasty; Fracture; Pain palliation; Percutaneous fixation; Screw; Sternum.