Bone is one of the most common metastatic areas in the cancer patient. Bone metastasis is the major cause to deteriorate the quality of life due to severe pain, walking difficulty, paraplegia, and pathologic fracture. To maintain patient’s general condition and continue scheduled medical treatment, various minimally invasive surgical methods have been developed. The percutaneous methods including alcohol or bone cement (polymethyl methacrylate [PMMA]) injection, laser or radiofrequency ablation, cryosurgery, and MRI-HIFU have shown favorable outcomes in the spine, pelvis, and other flat bones. Using only these percutaneous methods have high risk of pathologic fracture in the long bone of extremity, which needs some metallic fixation. Therefore, the new surgical method and instrument involving percutaneous internal fixation with PMMA bone cement injection have been introduced. The PMMA bone cement injection is effective in the metastatic bone tumor, providing reliable mechanical augmentation of destructive bone, durable local tumor suppression, and effective pain relief. The hollow-perforated screw and nail (multihole injection screw and nail) has central canal and multiple side holes to facilitate injection of bone cement to the bone lesion. An optimal customized surgical option according to the patient’s circumstances should be planned.
Part of the book: Tumor Metastasis