Abstract
Sternal metastasis often result in disabling pain, significant functional limitations, with potential consequences for the thoracic spine. This case report suggests a new approach combining ultrasound for initial guidance and fluoroscopy with cone-beam CT (CBCT) for screw fixation. The patient experienced immediate pain relief, a better mobility, and improved quality of life. This approach demonstrates a minimally invasive, radiation-sparing and time saving strategy for sternal screwing.