title: Long-Term Benefits of Percutaneous Anatomical Restoration of Vertebral Compression Fractures Linked to Malignancy.
abstract: OBJECTIVE
  To evaluate the efficacy, feasibility and safety of a percutaneous anatomical vertebral body reduction for the treatment of VCF (vertebral compression fracture) linked to malignancy. Vertebroplasty and percutaneous kyphoplasty have played essential roles in the treatment of painful vertebral metastasis, although there are few reports with long survival that have evaluated the long-term efficacy, adjacent fractures and vertebral body (VB) re-collapse associated with these procedures. We aimed to evaluate the longterm efficacy and the complications associated with malignancy and changes in spinal biomechanics.
  
  
  METHODS
  The retrospective study examined 32 patients with osteolytic VCF due to malignant infiltration of the vertebral body. A visual analogue scale, the EQ5 and radiological analysis (i.e., X-ray and CT scan) were used to assess back pain, quality of life and complications.
  
  
  RESULTS
  Statistically significant reductions in anterior and central vertebral body heights (6.2 mm-19.6 ± 4.2 mm- and 5.8 mm- 16.7 ± 7.8 mm-, respectively) that resulted in reductions of the regional Cobb angles exceeding 30% were observed. There was also a statistically significant improvement in quality of life. The average survival was longer than those reported in most published articles, and the average follow-up period was 30.9 months.
  
  
  CONCLUSIONS
  Anatomical restoration (i.e., cortical ring reduction with endplate rebalancing) is potentially beneficial for a wellselected group of patients with spine metastases and long life expectancies because this procedure avoids the complications typical of these types of treatments (e.g., leakage, adjacent fractures and re-collapse).
authors.affiliation: Valladolid University Hospital, Spine Unit, Department of Orthopedic, Valladolid, Spain.
authors.forename: David Cesar
authors.initials: DC
authors.lastname: Noriega
authors.forename: Antonio
authors.initials: A
authors.lastname: Krüger
authors.forename: Ruben Hernandez
authors.initials: RH
authors.lastname: Ramajo
authors.forename: Francisco
authors.initials: F
authors.lastname: Ardura
authors.forename: MariFe
authors.initials: M
authors.lastname: Munoz
authors.forename: Soner
authors.initials: S
authors.lastname: Sahin
mesh_terms: D000368:Aged; D001416:Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods