Safety of percutaneous vertebroplasty for the treatment of metastatic spinal tumors in patients with posterior wall defects
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To assess the clinical effect of percutaneous vertebroplasty (PVP) in the treatment of metastatic spinal tumors in patients with posterior wall defect.
The treated vertebrae bodies were divided into four groups: group A, non-posterior vertebral wall defect; group B, posterior vertebral wall with cribriform defects; group C, posterior vertebral wall with local fragmentation defects; group D, posterior vertebral wall with severe defects. The injected volume of bone cement, visual analogue scale (VAS) score, Karnofsky Performance Scale (KPS), cement leakage and survival were analyzed.
The injected volume of bone cement for group A was significantly higher than posterior wall defect group (including group B, C, and D). No significant differences about the injected volume of bone cement among the posterior wall defect groups. The incidence of bone cement leakage for group A was not significantly different as compared to posterior vertebral wall defect group. However, there were significant differences with respect to the incidence of bone cement leakage among the posterior wall defect groups. In four groups the postoperative VAS pain scores and KPS were statistical different as comparison to the preoperative values. No statistical difference with respect to the VAS pain scores and KPS was observed at any time point between the non-posterior wall defect group and posterior wall defect group.
PVP can be an effective treatment for metastatic spinal tumors in patients with posterior wall deficiency; however, care should be taken to control the distribution of the bone cement due to the relatively high risk of cement leakage.
KeywordsSpinal metastasis Percutaneous vertebroplasty Posterior wall defect Metastatic Tumor Cement
This research was supported in part by Grants (no. 81260322/H1606, no. 81372322/H1606 and no. 81460440/H1606) from the National Natural Science Foundation of China, a Grant (no. 2012FB163) from the Natural Science Foundation of Yunnan Province, a Grant (no. 2011FB201) from the Joint Special Funds for the Department of Science and Technology of Yunnan Province-Kunming Medical University, and a Grant (no. D-201242) from the specialty fund of high-level talents medical personnel training of Yunnan province.
Conflict of interest
The authors have no conflict of interest to declare.
- 1.Shimazaki J, Higa T, Akimoto S, Masai M, Isaka S (1992) Clinical course of bone metastasis from prostatic cancer following endocrine therapy: examination with bone x-ray. In: Prostate Cancer and Bone Metastasis. Springer, pp 269–275Google Scholar
- 4.Gerszten PC, Welch WC (2000) Current surgical management of metastatic spinal disease. Oncology (Williston Park, NY) 14(7):1013–1024 (discussion 1024, 1029–1030)Google Scholar
- 7.Nazzaro J (1999) Metastatic spinal lesions. Spine Surgery: techniques, complication avoidance, and management, vol 1. New York, Churchill Livingstone, pp 679–695Google Scholar
- 25.Cotten A, Dewatre F, Cortet B, Assaker R, Leblond D, Duquesnoy B, Chastanet P, Clarisse J (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 200:525–530PubMedCrossRefGoogle Scholar