Skip to main content
SpringerLink
Log in

Vertebroplasty for metastasis

  • Review Article
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Vertebral metastases are frequently asymptomatic; however, the occurrence of a pathological (micro-)fracture may be associated with unremitting pain, instability, and even kyphoscoliotic deformity and require prompt and effective treatment. In symptomatic patients, the beneficial effect of conservative therapies requires too much time. Vertebroplasty (VP) may be an additional or even alternative local treatment modality for such patients. Currently, up to 80% of VP patients report important relief of metastasis-related pain. Ongoing deformity of the vertebral body is avoided. Morbidity rates are very low and the complication rates are markedly below 10%. Fatalities, if any, are almost always the result of cancer comorbidity rather than related to the VP procedure itself. The patient’s mobility is often improved, thus avoiding much of the comorbidity of prolonged conservative treatment and bed rest. VP can successfully be combined with chemotherapy, radiotherapy, neurodecompression, and instrumentation.

Even though VP is no panacea, it may be helpful to selected patients and instantly improve quality of life. Currently, VP has a solid basis for the palliative treatment of thoracic, lumbar, and sacral metastasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harrington, K.D. (1986). Metastatic disease of the spine. J Bone Joint Surg. Am. 68:1110–1115.

    PubMed  CAS  Google Scholar 

  2. Deramond, H., Depriester, C. and Toussaint, P. (1996). Vertébroplastie et radiologie interventionnelle percutanée dans les métastases osseuses: technique, indications, contre-indications. Bull Cancer Radiother. 83:277–282.

    PubMed  CAS  Google Scholar 

  3. Weill, A., et al. (1996). Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199:241–247.

    PubMed  CAS  Google Scholar 

  4. Cotten, A., et al. (1996). Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesions filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 200:525–530.

    PubMed  CAS  Google Scholar 

  5. Schaberg, J. and Gainor, B.J. (1985). A profile of metastatic carcinoma of the spine. Spine 10:19–20.

    Article  PubMed  CAS  Google Scholar 

  6. Jenis, L.G., Dunn, E.J. and An, H.S. (1999). Metastatic disease of the cervical spine. Clin. Orthop. 359:89–103.

    Article  PubMed  Google Scholar 

  7. Cotten, A., et al. (1998). Percutaneous vertebroplasty: state of the art. Radiographics 18:311–323.

    PubMed  CAS  Google Scholar 

  8. Deramond, H., Depriester, C., Galibert, P. and Le Gars, D. (1998). Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol. Clin. North Am. 36:533–546.

    Article  PubMed  CAS  Google Scholar 

  9. Murphy, K.J. and Deramond, H. (2000). Percutaneous vertebroplasty in benign and malignant disease. Neuroimaging Clin. North Am. 10:535–545.

    CAS  Google Scholar 

  10. Kaemmerlen, P., et al. (1989). Vertébroplastie percutanée dans le traitement des métastases. Technique et résultats. J. Radiol. 70:557–562.

    PubMed  CAS  Google Scholar 

  11. Cortet, B., et al. (1997). Intérêt de la vertébroplastie dans le traitement des métastases ostéolytiques et du myélome. Rev. Rhum. Ed. Fr. 64:189–195.

    Google Scholar 

  12. Chiras, J., et al. (1995). Vertébroplasties percutanées. Rev. Med. Interne 16:854–859.

    PubMed  CAS  Google Scholar 

  13. Galibert, P., Deramond, H., Rosat, P. and Le Gars, D. (1987). Note préliminaire sur le traitement des angiomes vertébraux par vertébroplastie acrylique percutanée. Neurochirurgie 33:66–68.

    Google Scholar 

  14. Galibert, P. and Deramond, H. (1990). La vertébroplastie acrylique percutanée comme traitement des angiomes vertébraux et des affections dolorigènes et fragilisantes du rachis. Chirurgie 116:326–335.

    PubMed  CAS  Google Scholar 

  15. Bascoulergue, Y., Duquesnel, J., Leclercq, R., Mottolese, C. and Lapras, C. (1988). Percutaneous injection of methyl methacrylate in the vertebral body for the treatment of various diseases: percutaneous vertebroplasty. Radiology 169(P):372 (abstract).

    Google Scholar 

  16. Deramond, H., Debussche, C., Pruvo, J.P. and Galibert, P. (1990). La vertébroplastie. Feuillets Radiol 30:262–268.

    Google Scholar 

  17. Levine, S.A., Perin, L.A., Hayes, D. and Hayes, W.S. (2000). An evidence-based evaluation of percutaneous vertebroplasty. Manag. Care 9:56–63.

    PubMed  CAS  Google Scholar 

  18. Wenger, M. and Markwalder, T.M. (1999). Surgically controlled, transpedicular methyl methacrylate vertebroplasty with fluoroscopic guidance. Acta Neurochir. 141:625–631.

    Article  CAS  Google Scholar 

  19. Wenger, M. and Markwalder, T.M. (2000). Percutaneous vertebroplasty for pain relief and spinal stabilization. (letter). Spine 25:2968–2969.

    Article  PubMed  CAS  Google Scholar 

  20. Wenger, M., Braun, M. and Markwalder, T.M. (2002). Vertébroplastie et kyphoplastie: une revue. Rev. Med. Suisse Romande 122:557–560.

    PubMed  Google Scholar 

  21. Do, H.M. (2000). Magnetic resonance imaging in the evaluation of patients for percutaneous vertebroplasty. Topics Magn. Reson. Imaging 11:235–244.

    Article  CAS  Google Scholar 

  22. Minart, D., Vallée, J.N., Cormier, E. and Chiras, J. (2001). Percutaneous coaxial transpedicular biopsy of vertebral body lesions during vertebroplasty. Neuroadiology 43:409–412.

    Article  CAS  Google Scholar 

  23. Boriani, S., et al. (1996). En bloc resection of bone tumors of the thoracolumbar spine. A preliminary report on 29 patients. Spine 21:1927–1931.

    Article  PubMed  CAS  Google Scholar 

  24. Abe, E., et al. (2001). Total spondylectomy for primary malignant, aggressive benign, and solitary metastatic bone tumors of the thoracolumbar spine. J. Spinal Disord. 3:237–246.

    Article  Google Scholar 

  25. Chiras, J., Depriester, C., Weill, A., Sola-Martinez, M.T. and Deramond, H. (1997). Vertébroplasties percutanées. Technique et indications. J. Neuroradiol 24:45–59.

    PubMed  CAS  Google Scholar 

  26. Dufresne, A.C., Brunet, E., Sola-Martinez, M.T., Rose, M. and Chiras, J. (1998). Vertébroplastie percutanée de la charnière cervico-dorsale par voie antérieure. Technique et résultats. A propos de neuf cas. J. Neuroradiol. 25:123–128.

    PubMed  CAS  Google Scholar 

  27. Tong, F.C., Cloft, H.J., Joseph, G.J., Rodts, G.R. and Dion, J.E. (2000). Transoral approach to cervical vertebroplasty for multiple myeloma. Am. J. Roentgenol. 175:1322–1324.

    CAS  Google Scholar 

  28. Wetzel, S.G., Martin, J.B., Somon, T., Wilhelm, K. and Rüfenacht, D.A. (2002). Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty. Spine 27:E493-E495.

    Article  PubMed  Google Scholar 

  29. Martin, J.B., et al. (1999). Vertebroplasty: clinical experience and follow-up results. Bone 25:11S-15S.

    Article  PubMed  CAS  Google Scholar 

  30. Murray, J.A., Bruels, M.C. and Lindberg, R.D. (1974). Irradiation of polymethylmethacrylate. In vitro gamma radiation effect. J. Bone Joint Surg. Am. 56:311–312.

    PubMed  CAS  Google Scholar 

  31. Gangi, A., et al. (1998). CT-guided interventional procedures for pain management in the lumbosacral spine. Radiographics 18:621–633.

    PubMed  CAS  Google Scholar 

  32. Hierholzer, J., et al. (2002). Perkutane Vertebroplastie. Fortschr. Röntgenstr. 174:328–334.

    Article  CAS  Google Scholar 

  33. Fourney, D.R., et al. (2003). Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J. Neurosurg. (Spine 1) 98:21–30.

    Article  Google Scholar 

  34. Liebschner, M.A., Rosenberg, W.S. and Keaveny, T.M. (2001). Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine 26:1547–1554.

    Article  PubMed  CAS  Google Scholar 

  35. Batson, O.V. (1940). The function of vertebral veins and their role in the spread of metastases. Arch. Surg. 112:138–149.

    CAS  Google Scholar 

  36. Chiras, J. and Deramond, H. (1995). Complications des vertébroplasties, in Echecs et complications de la chirurgie du rachis. Chirurgie de reprise. (Saillant, G. and Laville, C., eds.), pp149–153. Sauramps médical, Paris.

    Google Scholar 

  37. Harrington, K.D. (2001). Major neurologic complications following percutaneous vertebroplasty with PMMA: a case report. J. Bone Joint Surg. Am. 83:1070–1073.

    PubMed  Google Scholar 

  38. Lee, B.J., Lee, S.R. and Yoo, T.Y. (2002). Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate. A case report. Spine 27:E419-E422.

    Article  PubMed  Google Scholar 

  39. Ratliff, J., Nguyen, T. and Heiss, J. (2001). Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 26:E300-E302.

    Article  PubMed  CAS  Google Scholar 

  40. San Millán Ruíz, D., et al. (1999). Pathology findings with acrylic implants. Bone 25:85S-90S.

    Article  PubMed  Google Scholar 

  41. Deramond, H., Wright, N.T. and Belkoff, S.M. (1999). Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25:17S-21S.

    Article  PubMed  CAS  Google Scholar 

  42. Padovani, B., Kasriel, O., Brunner, P. and Peretti-Viton, P. (1999). Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. Am. J. Neuroradiol. 20:375–377.

    PubMed  CAS  Google Scholar 

  43. Jang, J.S., Lee, S.H. and Jung, S.K. (2002). Pulmonary embolisma of polymethylmethacrylate after percutaneous vertebroplasty. A report of three cases. Spine 27:E416-E418.

    Article  PubMed  Google Scholar 

  44. Bernhard, J., Heini, P.F. and Villiger, P.M. (2003). Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty. Ann. Rheum. Dis. 62:85–86.

    Article  PubMed  CAS  Google Scholar 

  45. Chen, H.L. (2002). A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth. Analg. 95:1060–1062.

    Article  PubMed  Google Scholar 

  46. Tozzi, P., et al. (2002). Management of pulmonary embolism during acrylic vertebroplasty. Ann. Thorac. Surg. 74:1706–1708.

    Article  PubMed  Google Scholar 

  47. Cunin, G., Boissonnet, H., Petite, H., Blanchat, C. and Guillemin, G. (2000). Experimental vertebroplasty using osteoconductive granular material. Spine 25:1070–1076.

    Article  PubMed  CAS  Google Scholar 

  48. Heini, P.F. and Berlemann, U. (2001). Bone substitutes in vertebroplasty. Eur. Spine J. 10:S205-S213.

    Article  PubMed  Google Scholar 

  49. Ludwig, S.C. and Boden, S.D. (2000). Osteoinductive bone graft substitutes for spinal fusion. A basic science summary. Orthop. Clin. North Am. 30:635–645.

    Article  Google Scholar 

  50. Wang, H.M., et al. (1995). Methotrexate loaded acrylic cement in the management of skeletal metastases. Biomechanical, biological, and systemic effect. Clin. Orthop. 312:173–186.

    PubMed  Google Scholar 

  51. Vasconcelos, C., Gailloud, P., Martin, J.B. and Murphy, K.J. (2001). Transient arterial hypotension induced by PMMA injection during percutaneous vertebroplasty. J. Vasc. Interv. Radiol. 12:1001–1002.

    Article  PubMed  CAS  Google Scholar 

  52. Aebli, N., et al. (2002). Fat embolism and acute hypotension during vertebroplasty. An experimental study in sheep. Spine 27:460–466.

    Article  PubMed  Google Scholar 

  53. Kaufmann, T.J., et al. (2002). Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty. Am. J. Neuroradiol. 23:601–604.

    PubMed  Google Scholar 

  54. Liebermann, I.C.H., et al. (2001). Initial outcomes and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26:1631–1638.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurosurgery, The Hirslanden Group, Klinik Beau-Site, Schänzlihalde 11-13, CH-3000, Bern 25, Switzerland

    Markus Wenger

Authors
  1. Markus Wenger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Markus Wenger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wenger, M. Vertebroplasty for metastasis. Med Oncol 20, 203–209 (2003). https://doi.org/10.1385/MO:20:3:203

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1385/MO:20:3:203

Key Words

Search

Navigation