The efficacy of percutaneous vertebroplasty for palliation of pain in vertebral metastases associated with solid malignancies

Abstract

e20670 Background: Painful vertebral metastases are a debilitating and common complication of a number of solid malignancies. Percutaneous vertebroplasty appears beneficial for patients with acute compression fractures of multiple aetiologies including myeloma, and osteoporosis. There are few reports on its use in the setting of metastatic solid malignancy. Methods: We identified all individuals who had undergone percutaneous vertebroplasty at our institution since 2004 and focused on those with metastatic solid malignancies. Their clinical characteristics and outcomes were investigated. Results: From 136 cases that underwent percutaneous vertebroplasties, 19 were performed mainly in breast, prostate, lung, and renal cancers. Of these 19 cases, ten patients (53%) were treated for solitary lesions, 3 (16%) were injected at two levels and the remaining 6 cases (31%) underwent cement injection at three levels. The majority of patients (84%) reported short (within 48 hours) and longer term symptomatic improvements. At a median follow up of one year, 6 patients have died. Conclusions: This study illustrates that percutaneous vertebroplasty can be a safe and beneficial palliative procedure for patients with pain related to metastatic vertebral disease. Up to three vertebral levels maybe injected at one sitting with good results. Its use can be successfully combined with other treatment modalities (radiotherapy and chemotherapy). For optimal results its use before radiotherapy has been recommended. Although it does not improve the survival outcome, palliation is a reasonable goal when life expectancy is short. Cost benefits from this procedure will come from reduced analgesic requirements and avoided complications of long-term bed rest, with significant potential savings from reduced in-patient admissions for pain control, home care costs, community nursing, and out-of ours access to clinical services. No significant financial relationships to disclose.