Cement Augmentation For Vertebral Osteolytic Metastatic Lesions:An Evaluation Of The Efficacy On Postoperative CT

OBJECTIVE To evaluate the effectiveness of cement augmentation on the osteolytic lesion in patients with vertebral metastasis.METHOD A total of consecutive 132 patients with 268 vertebral metastatic lesions treated with PVP from January 2008 to December 2016 in our hospital were enrolled in this study.Retrospective analysis of preoperative,postoperative 3 days,3 months,6months,12months and≥18 months imaging data on CT,the local control and progression of the tumor were evaluated by MDA response criteria.The local control rates were compared between the groups with the different rate of cement filling by Chi~2-test.RESULT Vertebroplasty procedures were performed successfully in all 268 vertebrae under DSA guidance,and the mean volume of PMMA injected in each vertebra was 3.9±1.5ml.The rate of local control at 3 months,6months,12 months and≥18 months after PVP was 98.88%,95.09%,91.76%,and 85.18%,the difference was statistically significant(P<0.05).The local control rate showed a statistically significant relationship to the groups with the rate of cement filling at 6 months,12 months and≥18 months after PVP,but there was no significant difference at postoperative 3 months.The rate of local control was higher in 68 patients with lung or gastrointestinal cancer than in 17 patients with liver or kidney cancer at 3 months,6 months and 12 months,the difference was statistically significant(P<0.05).CONCLUSION Cement augmentation has a local antitumor effect on vertebral osteolytic metastatic lesion,and the antitumor effect will decrease as the follow-up time extended.