[Treatment of metastatic thoracolumbar tumors by percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds].
OBJECTIVE
To explore the value of percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds in the treatment of metastatic thoracolumbar tumors.


METHODS
Based on the CT images before ¹²⁵I seed implantation, a computer-based treatment planning system (TPS) was used to determine the optimal seed distribution. Under CT guidance and local anaesthesia, ¹²⁵I seeds were implanted into 22 osseous metastatic lesions in 18 patients. Based on the CT images after the implantation, quality check was carried out with TPS. DSA (digital subtraction angiography)-guided vertebroplasty was performed under local anaesthesia, and bone cement was injected into the vertebrae through pedicle of vertebral arch.


RESULTS
All the 18 patients received percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds. Every vertebra was injected with 2-6 ml bone cement, average 3.5 ml, and was injected with ¹²⁵I seeds 16-34 pills, average 26 pills. At 2-months follow-up, their numerical rating scale (NRS) pain scores were 7.12 ± 1.48 before and 2.26 ± 1.07 after treatment, with a significant difference (P < 0.05).


CONCLUSIONS
Percutaneous vertebroplasty combined with interstitial implantation of ¹²⁵I seeds is a minimally invasive procedure with small wound and minor complications, and no need of external radiation therapy. It is effective in the alleviation of pain in metastatic thoracolumbar tumor patients, restrains the tumor growth, and improves the quality of life. It is a promising minimally invasive method in the treatment of metastatic thoracolumbar tumors.
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China. Eamil: huanghaiskysea@sina.com.
Hai
H
Huang
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China.
Shaonian
S
Xu
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China.
Zhenguang
Z
Du
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China.
Fusheng
F
Li
Department of Orthopedic Oncology, the People's Hospital of Liaoning Province, Shenyang, 110016, China.
Liang
L
Wang
D000368:Aged; D015901:Angiography, Digital Subtraction; D001843:Bone Cements / Q000627:therapeutic use*; D001918:Brachytherapy; D001943:Breast Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008159:Lumbar Vertebrae; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011471:Prostatic Neoplasms / Q000473:pathology; D011788:Quality of Life; D011880:Radiotherapy Planning, Computer-Assisted; D013125:Spinal Neoplasms / Q000556:secondary / Q000628:therapy*; D013904:Thoracic Vertebrae; D054854:Vertebroplasty / Q000379:methods*
D001843:Bone Cements; D007457:Iodine Radioisotopes