Efficacy And Safety Of Percutaneous Vertebroplasty In The Treatment Of Non-small Cell Lung Cancer Patient With Spinal Metastasis

Purpose To study the efficacy and safety of percutaneous vertebroplasty in the treatment of non-small cell lung cancer patients with spinal metastasis.Methods Retrospectively analyses the NSCLC patients with spinal metastasis who were treated by PVP in our hospital from October 2015 to July 2018.All patients were selected by inclusion and exclusion criteria strictly.Patients' level of pain were evaluated by Visual Analogue Scale(VAS)and the quality of life were evaluated by Karnofsky Performance Score(KPS).All patients received VAS and KPS scores 1 day before surgery,1 day after surgery,3 days after surgery,and 1 month after surgery.The correlation scores were compared after surgery and statistical software was used to analyze the results and draw relevant conclusions.During and after PVP,X-ray fluoroscopy was performed,and complications such as bone cement leakage were found in time.During the period of hospitalization,inflammatory indicators such as leukocyte and erythrocyte sedimentation rate were detected,operative wound conditions were observed,and basic vital signs of the patients were monitored to find or exclude postoperative complications such as infection and pulmonary embolism.Postoperative outpatient follow-up,review of imaging examination to evaluate whether the patient has adjacent vertebral body fractures and other complications.Results A total of 46 patients were enrolled in this study,and all of them received PVP successfully.Among them,27 cases were male,accounting for 58.7%,19 cases were female,accounting for 41.3%.There were 84 vertebral bodies,including 37 thoracic vertebra,46 lumbar vertebra and 1 sacral vertebra.The average age of the patients was 58.57±10.47 years old,with the youngest patient 28 years old and the oldest patient 82 years old.VAS scores on the first day after surgery(2.93±1.38),the third day after surgery(2.00±1.26),and the first month after surgery(2.28±1.39)were significantly lower than those before surgery(7.28±0.98)(P < 0.05).There was a significant difference in VAS score between the first day after surgery and the third day after surgery.There was no significant difference in VAS score on the third day after surgery and 1 month after surgery.The KPS scores were 66.09±10.43,76.52±10.15,80.65±9.75 and 78.91±9.00 on the first day before surgery,the first day after surgery,the third day after surgery and the first month after surgery,respectively.The scores of the three times after surgery were significantly improved compared with those before surgery,with statistically significant differences(P < 0.05).There was no significant difference in KPS score on the third day after surgery compared with the first month after surgery.PVP related complications occurred in 10 patients among the 84 vertebral bodies of all the 46 patients.Cement leakage was confirmed by X-ray fluoroscopy in 8 patients: 6 to adjacent disks,1 into the path of the trocar and 1 into paravertebral vein.Two patient's pain did not improve significantly after PVP.None of the complications related to cement leakage had obvious clinical symptoms.No patients had pulmonary embolism,needle metastasis,paravertebral hematoma,infection or other complications.Conclusion PVP can alleviate the pain of patients with spinal metastasis from NSCLC,with significant analgesic effect and short onset time.It can also improve the patients' physical condition and improve their quality of life.PVP is a good palliative therapy for patients with spinal metastasis from advanced NSCLC with few complications and high safety.