Percutaneous Vertebroplasty for Palliative Treatment of Painful Osteoblastic Spinal Metastases: A Single-Center Experience

• Published in: Journal of vascular and interventional radiology Vol. 27; no. 9; pp. 1420 - 1424
• Main Authors: Tian, Qing-Hua, MD, Sun, Xi-Qi, MD, Lu, Ying-Ying, MD, Wang, Tao, MD, Wu, Chun-Gen, MD, PhD, Li, Ming-Hua, MD, PhD, Cheng, Ying-Sheng, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2016
• Subjects: Adult; Aged; Back Pain - diagnosis; Back Pain - etiology; Back Pain - therapy; China; Disability Evaluation; Female; Fluoroscopy; Fractures, Spontaneous - diagnostic imaging; Fractures, Spontaneous - etiology; Fractures, Spontaneous - pathology; Fractures, Spontaneous - therapy; Humans; Karnofsky Performance Status; Magnetic Resonance Imaging; Male; Middle Aged; Osteoblasts - pathology; Pain Measurement; Palliative Care - methods; Radiography, Interventional - methods; Radiology; Retrospective Studies; Spinal Fractures - diagnostic imaging; Spinal Fractures - etiology; Spinal Fractures - pathology; Spinal Fractures - therapy; Spinal Neoplasms - complications; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - secondary; Spinal Neoplasms - therapy; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vertebroplasty - adverse effects; Vertebroplasty - methods; Oswestry Disability Index; polymethyl methacrylate; Karnofsky Performance Scale; PMMA; ODI; percutaneous vertebroplasty; VAS; PVP; visual analog scale; KPS
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2016.04.033

Abstract Purpose To evaluate safety and efficacy of fluoroscopy-guided percutaneous vertebroplasty (PVP) for painful osteoblastic spinal metastases. Materials and Methods PVP was performed in 39 consecutive patients (median age, 60.1 y ± 9.5) with 51 osteoblastic metastatic spinal lesions; 14 patients had pathologic fractures. The patients were followed for 3–30 months (average, 14.5 mo ± 7.4). Visual analog scale (VAS), Oswestry Disability Index (ODI), and Karnofsky performance scale (KPS) were used to evaluate pain, quality of life, and performance status before the procedure and at 3 days and 1, 3, 6, 12, and 18 months after the procedure. Results Technical success was achieved in all patients. Minimal follow-up time was 3 months. Mean VAS scores declined significantly from 7.4 ± 1.1 before the procedure to 2.5 ± 0.9 by day 3 after the procedure and were 2.1 ± 1.1 at 1 month, 2.0 ± 1.1 at 3 months, 1.9 ± 1.1 at 6 months, 1.8 ± 0.9 at 12 months, and 1.7 ± 0.7 at 18 months after the procedure ( P < .001). ODI and KPS scores also changed after the procedure, with significant differences between baseline scores and at each follow-up examination ( P < .001). Extraosseous cement leakage occurred in 15 cases without causing any clinical complications. Conclusions PVP is a safe and effective treatment for painful osteoblastic spinal metastases. It can relieve pain, reduce disability, and improve function.