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Vertebroplasty shows no antitumoral effect on vertebral metastasis: a case-based study on anatomopathological examinations

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Abstract

Purpose

Percutaneous vertebroplasty (VTP) is a well-known surgical technique used for pain management and vertebral consolidation in the treatment of osteolytic metastases of the spine.

While this indication is proven and commonly accepted, an antitumoral effect of polymethylmethacrylate (PMMA) has been proposed but not yet demonstrated.

The aim of our study is to evaluate the evidences of antitumoral effect on anatomopathological examination. We present a small series of pathology findings after VTP for spine metastases that support the lack of antitumoral effect of PMMA.

Methods

We have retrospectively analyzed three cases of patients treated for en bloc excision of recurrent spine metastases previously submitted elsewhere to VTP on the same levels.

We discuss our results with the literature reporting of an antitumoral effect of VTP.

Results

In our series, after anatomopathological examination, a cement-induced tumor necrosis was never found. Conversely, a foreign-body reaction around the cement was found, inside vital tumor. These results are consistent with an immune reaction to a foreign body without evidences of an antitumoral effect of PMMA.

Conclusion

The antitumoral effect of PMMA should not be taken into account as an indication for VTP in spinal metastases. It is important not to misuse VTP as a therapy aiming at tumor control. Other therapies such as radiotherapy, radiosurgery and open surgery are available for that purpose.

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Acknowledgements

The authors are indebted to Mr. Carlo Piovani for archive database research and images selection.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. GSpine4, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy

    Alberto Balestrino, Stefano Boriani & Riccardo Cecchinato

  2. Division of Neurosurgery, Department of Neurosciences (DINOGMI), IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Alberto Balestrino

  3. Department of Pathology, Orthopaedic Institute Gaetano Pini, Milan, Italy

    Antonina Parafioriti

  4. Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Marco Gambarotti

  5. Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Alessandro Gasbarrini

Authors
  1. Alberto Balestrino
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  2. Stefano Boriani
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  3. Riccardo Cecchinato
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  4. Antonina Parafioriti
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  5. Marco Gambarotti
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  6. Alessandro Gasbarrini
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Contributions

SB and AG conceived the study; AB drafted the manuscript; SB, AG and RC revised the manuscript. AB and RC reviewed the literature. AP and MG provided histopathological images and their commentaries. All authors critically revised the manuscript. All authors have read and approved the latest version of the manuscript.

Corresponding author

Correspondence to Riccardo Cecchinato.

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Conflicts of interest

The authors declare that they have no conflict of interest or competing interests.

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Formal patient consent is not required for the present paper. No data from which individual can be identified are present.

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Cite this article

Balestrino, A., Boriani, S., Cecchinato, R. et al. Vertebroplasty shows no antitumoral effect on vertebral metastasis: a case-based study on anatomopathological examinations. Eur Spine J 29, 3157–3162 (2020). https://doi.org/10.1007/s00586-020-06555-9

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  • DOI: https://doi.org/10.1007/s00586-020-06555-9

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