Are there specific patient or lesion characteristics (e.g., osteoporotic vs. neoplastic, fracture location, bone quality) that predict better outcomes with cementoplasty alone versus cementoplasty combined with screw fixation? Dr. Grange: Excellent question! In recent years, particularly in France, image-guided screw fixation has been increasingly explored and validated. Its feasibility and efficacy in terms of pain reduction, mobility and quality of life— both short- and long-term—have been well demonstrated. The next challenge is to determine, through prospective randomized studies, whether adding screw fixation to cementoplasty improves outcomes compared with cement alone, and to define which patient subgroups (osteoporotic fractures, pathological fractures, poor bone quality, etc.) benefit most from this combined approach.
Bone consolidation is a critical issue in IR because it concerns both pediatric and elderly patients, and it involves a wide spectrum of conditions ranging from primary bone diseases to metastatic lesions.
What are the mid- and long-term follow-up results beyond 1 month, particularly regarding sustained pain relief, functional independence and any late complications or hardware failures? Dr. Grange: In our cohort of elderly patients, we observed no significant long-term complications during follow-up. However, screw loosening is a potential event that can occur in some cases. Importantly, this complication can usually be managed effectively and safely by interventional radiologists, often with minimally invasive revision procedures. Longer- term multicenter data will be valuable to confirm these findings.
30 IRQ | FALL 2025
How might this research influence treatment, practice or clinical processes in interventional radiology? Dr. Grange: This research highlights that percutaneous bone consolidation procedures can be safely performed even in very elderly and fragile patients, often under local anesthesia. These approaches provide a valuable alternative to open surgery, minimizing procedural risks and hospital stay. In most cases, patients are able to regain mobility quickly and return home within a short period, which is particularly beneficial for maintaining independence and quality of life.
Any next steps or plans for follow-up research? Dr. Grange: Yes! Our next step is to refine patient selection and establish clearer guidelines on the optimal indications for different percutaneous consolidation techniques, including sclerotherapy, cementoplasty, screw fixation and other hardware solutions. We plan to conduct prospective studies and, ideally, randomized controlled trials to better define the comparative benefits of these strategies.
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