Application Of Vertebroplasty In The Treatment Of Vertebral Tumor

Objective To evaluate the indication and clinical efficacy of vertebroplasty and open vertebroplasty in the treatment of spinal metastases, hemangioma and multiple myeloma.Materials and Methods From February 2003 to May 2009,12 patients underwent vertebroplasty. There were 7 men,5 women. Their mean age was 55.58(range,38-78).5 of 12 patients underwent percutaneous vertebroplasty.7 of them underwent posterior spinal cord decompression, internal fixation and vertebroplasty during the same operation. There were 8 patients with multiple myeloma,1 with hemangioma and 3 with metastases, including 1 with lung cancer,1 with renal carcinoma and 1 with neuroendocrine tumor.17 levels were treated.10 thoracic vertebarl bodies and 7 lumbar vertebral bodies were affected.1 patient underwent preoperative radiotherapy.1 patient underwent preoperative chemotherapy. All patients complained severe back or lumbar pain. The mean visual analog scale (VAS) was 6.8±0.99. Spinal compression and neurological deficits of lower limb preoperatively were seen in 2 patients. According to system of Frankel and neurological function,1 patient was grade B.1 was grade C. All percutaneous vertebroplasty were unipedicular.ResultsThe alleviation of pain and capability of movement were reevaluated on 1 week,3 months,6 months and 12 months after operation. All patients were followed up. The mean follow-up period was 37 months. The pain was dramatically reduced 3 days after operation. The movement capability was improved. The patients were satisfied. The mean VAS decreased to 1.0±0.71. The difference is statistical (P＜0.01). Two patients recovered from grade B and C to grade D after operation. The mean injection volume of cement was 3 ml. Cement leakage was revealed in 1 patient (figure 1). All patients suffered from multiple myeloma received postoperative chemotherapy. No procedure-related complications occurred. We did not find deteriorated vertebral body get worse and compression fracture of consecutive vertebral body.ConclusionsVertebroplasty can reduce the pain from tumor of thoracic and lumbar vertebral body satisfyingly, consolidate the vertebral body, prevent pathological fracture of deteriorated vertebral body and improve living quality. It was demonstrated by evidence-based medicine. It has been an effective way to treat osteolytic tumor. Incompleteness of posterior wall of vertebral body was contraindication of PVP and PKP. Open vertebroplasty can monitor the cement leakage in the spinal canal and be used widely. The patients suffered from spinal metastases and multiple myeloma were in poor general health and not able to bear the anterior vertebrectomy or anterior and posterior combined vertebrectomy, decompression of spinal canal. The open vertebroplasty can alleviate the spinal cord symptoms and stabilizate vertebral volumn. It can reduce operative time, surgical trauma and risks. This group of cases conformed the safety and efficacy of PVP, PKP and open vertebroplasty. This procedure provide an alternative treatment for the patients with spinal metastases and multiple myeloma. Better results of pain relief and neurologic recovery and living quality can be achieved.