title: Percutaneous vertebroplasty for pain management in malignant fractures of the spine with epidural involvement.
abstract: OBJECTIVE
  To evaluate the feasibility, efficacy, and safety of percutaneous vertebroplasty (PV) in the treatment of pathologic fractures owing to malignancy with epidural involvement, with or without neurologic symptoms of spinal cord or cauda equina compression.
  
  
  METHODS
  This study was approved by the local ethics committee; informed consent was obtained from all patients. This retrospective review was performed for 51 consecutive patients with metastatic disease or multiple myeloma treated by means of vertebroplasty, who presented with at least one vertebral lesion with epidural involvement, with or without clinical symptoms of spinal cord or cauda equina compression. All patients with neurologic deficit were terminally ill. A neurologic examination was performed before and after treatment in all patients. All imaging examinations and treatments were reviewed, and chi(2), Mann Whitney, or Fisher exact testing was performed for univariate analysis of variables.
  
  
  RESULTS
  A total of 74 vertebrae were treated in 51 patients, 22 women and 29 men with a mean age of 62.5 years (range, 28-85 years). Fifteen (29%) patients presented symptoms of complete or incomplete spinal cord or cauda equina compression before vertebroplasty and no further clinical deterioration was observed after treatment. The analgesic efficacy of vertebroplasty was satisfactory for 94% (48 of 51) of patients after 1 day, 86% (31 of 36) patients after 1 month, and 92% (11 of 12) patients after 1 year. One patient with no clinical neurologic deficit before treatment experienced symptoms of cauda equina compression 2 days after vertebroplasty. No other major complication was observed.
  
  
  CONCLUSIONS
  The feasibility, efficacy, and safety of PV were confirmed in patients experiencing pain related to malignant spinal tumors with epidural extension, with a low complication rate. PV should become part of the palliative analgesic treatment for such patients. (c) RSNA, 2010.
authors.affiliation: Department of Neuroradiology, Hôpital Nord, 2 place Victor Pauchet, 80054 Amiens, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Saliou
authors.forename: El Moncef
authors.initials: el M
authors.lastname: Kocheida
authors.forename: Pierre
authors.initials: P
authors.lastname: Lehmann
authors.forename: Claude
authors.initials: C
authors.lastname: Depriester
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Paradot
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Gars
authors.forename: Antonia
authors.initials: A
authors.lastname: Balut
authors.forename: Hervé
authors.initials: H
authors.lastname: Deramond
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010146:Pain / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements