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<dcterms:abstract xml:lang="fr">La cimentoplastie extra-rachidienne est une intervention percutanée guidée par l’image qui consiste à injecter du ciment acrylique, du polymethylmétacrylate (PMMA) le plus souvent, au sein d’un os pathologique. Le but est non seulement de traiter la douleur mais aussi de renforcer la tenue mécanique de l’os notamment au niveau du bassin. Dans cet optique, le volume de ciment et la technique d’injection pourraient être des facteur prédictifs de succès du geste. Le but de ce travail est de faire un état de l’art sur la cimentoplastie extra-rachidienne, le PMMA et sur la biomécanique du bassin afin d’identifier les axes potentiels de développement de la technique. Une étude des pratiques cliniques est également réalisée. S’en suit la présentation des résultats de travaux précliniques sur l’influence du volume de ciment et de la technique d’injection d’un volume de PMMA supérieur à 10 ml. Puis 3 axes d’assistance à l’injection d’un volume de plus de 10 ml sont présentés et évalués.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Extra-spinal cementoplasty is a percutaneous image-guided intervention whereby acrylic bone cement, polymethylmetacrylate (PMMA) most exclusively, is injected inside a pathological bone. The goal is to alleviate the pain and to provide bone consolidation, notably in the osseous pelvis. In this perspective, the volume of bone cement and the technique of injection may predict the outcomes of the procedure. The purpose of the thesis is to perform a state-of-the-art review of extra-spinal cementoplasty, PMMA and the biomechanics of the osseous pelvis in order to identify technical details that may be improved. A retrospective analysis of the clinical practice is also presented. The mechanical influence of the volume of bone cement and a comparison of the different techniques of injection of a volume greater than 10 ml are then evaluated using numerical simulations and experiments on phantoms. Finally, assistance to the injection of a volume greater than 10 ml is presented and evaluated through 3 different approaches.</dcterms:abstract>
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