title: Safety and efficacy of percutaneous vertebroplasty and interventional tumor removal for metastatic spinal tumors and malignant vertebral compression fractures.
abstract: OBJECTIVE
  The purpose of this study was to determine the safety and efficacy of percutaneous vertebroplasty and interventional tumor removal in the management of metastatic spinal tumors and malignant vertebral compression fractures.
  
  
  METHODS
  Thirty-one patients with metastatic spinal tumors and malignant vertebral compression fractures were treated with percutaneous vertebroplasty and interventional tumor removal. Insertion of a 14-gauge needle and guidewire into the vertebral body was followed by sequential dilation of the track with working cannulae until the last cannula reached the anterior portions of the pedicle. Interventional tumor removal was performed with marrow nucleus rongeurs, and 5-10 mL of cement was injected into the treated vertebra. Outcome data (visual analog scale score, Oswestry disability index score, and Karnofsky performance scale score) were collected preoperatively; 1 week and 1, 3, and 6 months after the procedure; and every 6 months thereafter until death.
  
  
  RESULTS
  The overall clinical assessment at the last follow-up evaluation showed that pain was completely resolved in 23 patients, decreased in six patients, and unimproved in two patients, yielding a pain relief rate of 94%. The average preoperative visual analog scale score was 7.2, which decreased to 2.4 at 1 month, 1.9 at 6 months, and 1.6 at 1 year and was maintained at 1.3 at the follow-up evaluations performed after more than 1 year. Statistically significant improvement in Oswestry disability index and Karnofsky performance scale scores was also seen between the preoperative evaluation and every follow-up assessment postoperatively (p<0.001).
  
  
  CONCLUSIONS
  Percutaneous vertebroplasty and interventional tumor removal are safe, effective, and minimally invasive palliative therapies for reducing pain and improving function in patients with metastatic spinal tumors and malignant vertebral compression fractures.
authors.affiliation: 1 All authors: Institution of Diagnostic and Interventional Radiology, Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, 600 Yi Shan Rd, Shanghai, 200233, China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Gu
authors.forename: Yong-Dong
authors.initials: YD
authors.lastname: Li
authors.forename: Chun-Gen
authors.initials: CG
authors.lastname: Wu
authors.forename: Zhen-Kui
authors.initials: ZK
authors.lastname: Sun
authors.forename: Cheng-Jian
authors.initials: CJ
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy*; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects* / Q000379:methods