Latest Developments in Surgical and Minimally Invasive Treatment of Metastatic Bone Disease

Abstract

Surgical treatment of metastatic disease to bone continues to evolve. Advances have been made in diagnosis, improved surgical outcomes, and minimally invasive procedures. Improved prediction of risk for bone fracture continues to evolve with CT-based techniques including structural rigidity analysis and finite element modeling. Improved surgical outcomes have been seen in treatment of proximal femoral pathologic lesions and fractures with the pendulum swinging toward more use of endoprosthetic devices over internal fixation, humeral lesions with a wide variety of techniques, and acetabular lesions with the use of tantalum acetabular cups and augments. Minimally invasive techniques including osteoplasty, radiofrequency ablation, cryoablation, and high-intensity ultrasound offer alternatives to open surgical treatment. Despite this evolution, the goals of treatment remain the same: pain relief, immediate stability, local disease control, and maintenance or restoration of function.