scholarly journals Shape-memory balloon offering simultaneous thermo/chemotherapies to improve anti-osteosarcoma efficacy

2021 ◽  
Vol 9 (20) ◽  
pp. 6957-6965
Author(s):  
Sosuke Ouchi ◽  
Eri Niiyama ◽  
Ken Sugo ◽  
Koichiro Uto ◽  
Satoshi Takenaka ◽  
...  

This paper proposes a shape-memory balloon (SMB) to improve bone cement injection efficiency and postoperative thermo/chemotherapy for bone tumors.

2014 ◽  
Vol 20 (4) ◽  
pp. 430-435 ◽  
Author(s):  
Tao Li ◽  
Jianmin Li ◽  
Zhen Wang ◽  
Baodong Liu ◽  
Dunfu Han ◽  
...  

Object Percutaneous vertebroplasty (PVP) combined with brachytherapy using the interstitial implantation of 125I seeds has previously yielded encouraging clinical results in the treatment of metastatic vertebral tumors. However, the bone cement injection volume is very small due to the osteolytic damage to the metastatic vertebrae, and the ideal spatial distribution of the 125I seeds is difficult to achieve. In the current study, the authors present a clinical method for puncture needle insertion to achieve a greater bone cement injection volume and a more ideal spatial distribution of the 125I seeds. Methods Twenty-nine patients with osteolytic metastatic vertebral tumors were divided into 2 groups and were treated with either PVP combined with multineedle interstitial implantation of 125I seeds, or PVP combined with single-needle interstitial implantation of 125I seeds. Clinical efficacy was evaluated according to a visual analog scale (VAS) of pain, the Karnofsky Performance Scale (KPS), and the Response Evaluation Criteria In Solid Tumors (RECIST). Results Back pain was significantly alleviated in all patients after surgery. Compared with the preoperative scores, the VAS scores were significantly decreased in both groups at 1 week and 3 months postoperatively (p < 0.05), but there were no significant intergroup differences (p > 0.05). The postoperative quality of life was improved in both groups; the KPS scores increased significantly compared with the preoperative scores (p < 0.05), and the postoperative KPS scores were significantly different between the 2 groups (p < 0.05). No intergroup differences were observed in pain alleviation, but the bone cement injection volume was significantly greater in the multineedle group than in the single-needle group (p < 0.05). The clinical benefit rate and disease control rate at 3 months after the operation were both significantly better for the multineedle group (p < 0.05). Conclusions The outcomes of PVP combined with multineedle interstitial implantation of 125I seeds in patients with osteolytic metastatic vertebral tumors appeared to be better than the outcomes of PVP combined with single-needle interstitial implantation of 125I seeds. These better outcomes may be the result of the greater bone cement injection volume and the more ideal spatial distribution of the 125I seeds.


1995 ◽  
Vol 5 (3-4) ◽  
pp. 124-130 ◽  
Author(s):  
A. J. Ward ◽  
E. J. Smith ◽  
J. W. Barlow ◽  
A. Powell ◽  
M. Halawa ◽  
...  

Two differing cementation methods were investigated in an in vitro simulation of hip arthroplasty. The bone-cement interface pressures were recorded during cement injection and stem insertion in matched pairs of fresh cadaveric femora. Reduced viscosity cement injected with a cement gun and proximal seal was compared with injection of high viscosity cement and finger-packing in each pair. The resultant shear strength of the bone-cement interface was measured by push-out tests. Results were analysed using the Wilcoxon ranked sum test for paired samples. The Exeter method of cementation produced significantly higher mean and maximum pressures above the bleeding pressure of femoral bone at all interface levels during cement injection. This was associated with significantly greater mean shear strengths. The authors conclude that the Exeter pressurization system for cementation overcomes the effect of femoral bone bleeding and improves the quality of the bone-cement interface. This may contribute to reduction in the incidence of loosening in cement hip arthroplasty.


2021 ◽  
Author(s):  
Erika L Cyphert ◽  
Nithya Kanagasegar ◽  
Ningjing Zhang ◽  
Greg D Learn ◽  
Horst A von Recum

Standard chemotherapy for primary and secondary bone tumors typically involves systemic administration of chemotherapeutic drugs, such as doxorubicin (DOX). However, non-targeted delivery increases dose requirements, and results in off target toxicity and suboptimal chemotherapeutic efficacy. When chemotherapy is ineffective, substantial resection of tissue and/or total amputation become necessary, a debilitating outcome for any patient. In this work, we developed a proof of concept, nonbiodegradable, mechanically robust, and refillable composite system for chemotherapeutic (i.e. DOX) delivery comprised of poly(methyl methacrylate) (PMMA) bone cement and insoluble polymeric γcyclodextrin (γCD) microparticles. The porosity and compressive strength of DOX-filled PMMA composites were characterized. DOX filling capacity, elution kinetics, cytotoxicity against primary osteosarcoma and lung cancer cells, and refilling capacity of composites were evaluated. PMMA composites containing up to 15wt% γCD microparticles provided consistent, therapeutically-relevant release of DOX with ~100% of the initial DOX released after 100 days. Over the same period, only ~6% of DOX was liberated from PMMA with free DOX. Following prolonged curing, PMMA composites with up to 15wt% γCD surpassed compressive strength requirements outlined by international standards for acrylic bone cements. Compared to DOX filled PMMA, DOX filled PMMA/γCD composites provided long term release with decreased burst effect, correlating to long term cytotoxicity against cancer cells. Refillable properties demonstrated by the PMMA composite system may find utility for treating local recurrences, limiting chemoresistance, and altering drug combinations to provide customized treatment regimens. Overall, findings suggest that PMMA composites have the potential to serve as a platform for the delivery of combinatorial chemotherapeutics to treat bone tumors.


2011 ◽  
Vol 6;14 (6;12) ◽  
pp. 539-544
Author(s):  
Sang Sik Choi

Background: Percutaneous balloon kyphoplasty is an effective, minimally invasive procedure that is used to relieve pain and stabilize spine fractures caused by severe osteoporosis or osteolysis due to tumor metastasis. However, there remains a risk of bone cement leakage during and after kyphoplasty, especially in cases with severe vertebral wall destruction or neurological deficits. Objective: This article presents a case in which kyphoplasty was used to manage these complications in a woman with vertebral compression fractures caused by tumor metastasis. Design: Case report. Setting: Pain management clinic. Methods: The patient was a 76-year-old woman who had severe low back pain, lower extremity weakness, and cauda equina syndrome because of vertebral compression fracture and spinal metastasis with epidural involvement. The patient had a large bony defect in the vertebra that the bone filler device could pass freely through the anterior body wall. Nevertheless, kyphoplasty was successfully performed by using our new cement injection technique, which is a slow injection of the highly viscous bone cement, followed by a second injection 10 minutes later to allow the previously injected cement to harden. Results: The procedure significantly alleviated all symptoms. The day after the procedure, in the absence of additional pain medication, the pain had dropped dramatically to a numerical rating scale 3-4, and there was an improvement in motor function that allowed the patient to sit and go to the bathroom by herself. In addition, the voiding sensation had returned, which allowed the patient to defecate and urinate normally. Limitations: This report describes a single case report. Conclusion: Our new cement injection technique may allow balloon kyphoplasty to be safely and effectively performed in cancer patients with pathological vertebral compression fractures, even if there are large defects in the anterior vertebral wall and neurological deficits. Key words: Compression fractures, kyphoplasty, metastasis, neurological deficits, osteolysis, polymethylmethacrylate.


2004 ◽  
Vol 15 (7) ◽  
pp. 707-712 ◽  
Author(s):  
Atsuhiro Nakatsuka ◽  
Koichiro Yamakado ◽  
Masayuki Maeda ◽  
Masayo Yasuda ◽  
Masao Akeboshi ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen Wang ◽  
Yu Zhang ◽  
Wang Chen ◽  
Shi-Lei Yan ◽  
Kai-Jin Guo ◽  
...  

Abstract Background Here we compared the clinical efficacy of bilateral percutaneous kyphoplasty (PKP) and percutaneous curved kyphoplasty (PCKP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods Seventy-two patients with single-level thoracolumbar OVCF were randomly divided into 2 groups (36 patients in each) and were subjected to either PCKP or bilateral PKP. The intraoperative fluoroscopy time, total surgical time, bone cement injection volume, bone cement leakage, preoperative and postoperative anterior vertebral height, Cobb angles, visual analog scales (VAS) and oswestry disability index questionnaire (ODI) were recorded. Results Both groups of patients had a trend towards improvements in VAS and ODI scores 24 h and 6 months after surgery, when compared to preoperative results, despite lack of statistical significance. The total surgical and intraoperative fluoroscopy times and intraoperative bone cement injection volume were significantly decreased in the PCKP group than those in the PKP group. The anterior edge height and Cobb angle of the injured vertebra were similarly improved after operation in both groups. Conclusion PCKP is safer, less invasive and quicker than traditional bilateral PKP despite similar short-term effects for the treatment of OVCF. Trial registration ChiCTR, ChiCTR2100042859. Registered 25 January 2021- Retrospectively registered.


2015 ◽  
pp. 97-107
Author(s):  
Dmitry Zhukov ◽  
◽  
Valery Prokhorenko ◽  
Alla Zaidman ◽  
Nina Ustikova ◽  
...  

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