Abstract
Interventional radiology expertise in image guidance has expanded the treatment options
for cancer patients with unstable osseous disease. Percutaneous fixation by internal
cemented screw (FICS) describes the technique by which the interventional radiologist
stabilizes a fracture or impending fracture with the percutaneous placement of a cannulated
screw that is locked in position by polymethyl methacrylate cement. The durable metallic
screws provide added resistance to torque and tension stresses that complement the
axial compression resistance of cement. Compared with cementoplasty alone, the procedure
has been advanced as a more durable and precise technique for stabilization of osseous
disease for certain disease presentations in cancer patients. The application of advanced
image guidance techniques improves upon existing percutaneous surgical techniques
to facilitate approaches that would otherwise prove quite challenging, particularly
with stabilization of the pelvic flat bones. This article examines the applications
of percutaneous FICS procedures for the treatment of unstable osseous disease in cancer
patients. Indications, techniques, and follow-up care are reviewed. Case examples
in which FICS can be performed in unstable pathology are detailed.
Keywords
bone fracture - pain palliation - cement consolidation - screw fixation - cementoplasty
- interventional radiology
