Effectiveness and safety of percutaneous vertebroplasty in the treatment of spinal metastatic tumor.

Yilin Liu,Ruipeng Song,Liang Zhao,Hongyu Tan,Limin Wang,Yuqiang Wang

doi:10.12669/pjms.333.12276

Abstract

Objective:To evaluate the effectiveness, safety and feasibility of percutaneous vertebroplasty in the treatment of spinal metastatic tumor.Methods:Thirty-four patients with spinal metastatic tumor who received treatment in the First Affiliated Hospital of Zhengzhou University from May 2014 to June 2015 were selected. Totally fifty diseased vertebrae were treated by percutaneous vertebroplasty. The curative effects were evaluated according to visual analogue scale (VAS) score, Oswestry Dability Index (ODI) and dose of pain reliever. The leakage conditions of bone cement and clinical complications were observed. The patients were followed up for 3 to 12 months.Results:The average VAS score and ODI 24 h after treatment were much lower than those before treatment, and the difference had statistical significance (P<0.05). The average VAS score and ODI at different follow-up periods after treatment were not significantly different (P>0.05). During follow up, nine patients stopped taking pain reliever, the dose of 18 patients had obvious reduction, and 7 patients kept previous dose; the incidence of bone cement leakage was 38.25%. Six patients had fever after surgery, but recovered after expectant treatment; 2 patients felt uncomfortable in the right lower limbs, but relieved after expectant treatment.Conclusion:Percutaneous vertebroplasty can relieve pain efficiently, improve the daily living ability, and significantly enhance the living quality of patients with spinal metastatic tumors, with small trauma and high safety.

Highlights

Bone metastasis is frequently seen in the spinal, and its incidence is 5% to 10% among tumor patients
This study aims at observing the clinical effects of percutaneous vertebroplasty in the treatment of spinal metastatic tumors and evaluate safety, to provide a reference for the clinical treatment
The patients underwent thoracolumbar spine computed tomography (CT) or Magnetic Resonance Imaging (MRI); 20 patients were diagnosed as pathological fracture in vertebrae, 15 patients had bone cortex rupture at vertebral posterior border, and 5 patients had nerve root compression, among which, 2 patients had weakened limbs muscle force

Summary

Introduction

Bone metastasis is frequently seen in the spinal, and its incidence is 5% to 10% among tumor patients. Pulmonary carcinoma and prostatic cancer are the most common primary lesions for patients with bone metastasis tumors.[1,2] Patients with spinal metastatic tumors usually have clinical manifestations such as intense pain, neurological disorders and paralysis, which brings huge pains for patients and severely affects the living quality and survival period of patients.[3]. The current treatment approaches for spinal metastatic tumors include chemotherapy, radiotherapy and surgery.[4] Radiotherapy is the most common therapy; but it cannot improve neurological function, especially spinal paralysis, by relieving spinal instability induced by tumors. Percutaneous vertebroplasty, a kind of minimally invasive spinal treatment technology, has been applied in the treatment of intractable pain in recent years and has achieved good effects.[5,6] This study aims at observing the clinical effects of percutaneous vertebroplasty in the treatment of spinal metastatic tumors and evaluate safety, to provide a reference for the clinical treatment

Methods

Results

Discussion

Conclusion