title: Safety and efficacy of percutaneous vertebroplasty in malignancy: a systematic review.
abstract: OBJECTIVE
  To establish the efficacy and complications associated with vertebroplasty in spinal metastases and myeloma.
  
  
  METHODS
  A literature search was performed from inception to April 2010. Thirty relevant studies were identified. Only one was a randomized, controlled trial and seven were prospective studies. Nine hundred and eighty-seven patients aged between 45 and 72 years were included in this systematic review.
  
  
  RESULTS
  Most studies report performing the procedure under local anaesthetic and continuous fluoroscopic screening, and only two centres reported treating more than four vertebrae per session. Five deaths were attributable to vertebroplasty, with a further 19 patients suffering a serious complication related to the procedure. There is some evidence to suggest that the complication rate may be related to the higher cement volume used, although the data are not robust enough for meta-analysis. Pain reduction ranged between 47-87%, similar to the results for osteoporosis. There was no correlation between pain reduction and cement volume.
  
  
  CONCLUSIONS
  This systematic review reveals the paucity of good-quality, robust data available on the subject of percutaneous vertebroplasty in malignancy. It also highlights the apparent high risk of serious complication (2%). Further research into the subject is required in this group of patients.
authors.affiliation: Department of Interventional Radiology, Gartnavel General Hospital, Glasgow, UK. chewszewan@aol.com
authors.forename: C
authors.initials: C
authors.lastname: Chew
authors.forename: L
authors.initials: L
authors.lastname: Craig
authors.forename: R
authors.initials: R
authors.lastname: Edwards
authors.forename: J
authors.initials: J
authors.lastname: Moss
authors.forename: P J
authors.initials: PJ
authors.lastname: O'Dwyer
mesh_terms: D000368:Aged; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D010166:Palliative Care; D011859:Radiography; D016032:Randomized Controlled Trials as Topic; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*