Percutaneous vertebroplasty and interventional tumor removal for malignant vertebral compression fractures and/or spinal metastatic tumor with epidural involvement: a prospective pilot study.
OBJECTIVE
The aim of this study was to compare the efficacy of percutaneous vertebroplasty (PVP) and interventional tumor removal (ITR), with PVP alone for malignant vertebral compression fractures and/or spinal metastatic tumor with epidural involvement.


METHODS
A total of 124 patients were selected for PVP and ITR (n = 71, group A) and PVP alone (n = 53, group B). A 14 G needle and guide wire were inserted into the vertebral body, followed by sequential dilatation of the tract until the last cannula reached the anterior portion of the pedicle. Tumors were then ablated with a radiofrequency probe. ITR was performed with marrow nucleus rongeurs, and then cement was injected into the extirpated vertebra. Outcomes were collected preoperatively and at 1, 3 and 6 months and every subsequent 6 months.


RESULTS
The rates of pain relief and increased mobility at the last follow-up were higher in group A than those in group B (P< 0.05). There were significant differences in visual analog scale (VAS) score and Oswestry disability index (ODI) score at 1, 3 and 6 months, 1 year and >1 year in group A than in group B (P< 0.05). The rates of paraplegia recovery and vertebral stability in group A were higher than those in group B (P< 0.05).


CONCLUSIONS
PVP and ITR proved to be an effective approach for patients with malignant vertebral compression fractures and/or spinal metastatic tumor and provided distinct advantages in pain relief, function recovery and vertebral stability that are comparable to that obtained with PVP alone.
Institute of Diagnostic and Interventional Radiology.
Yi-Feng
YF
Gu
Institute of Diagnostic and Interventional Radiology.
Qing-Hua
QH
Tian
Institute of Diagnostic and Interventional Radiology.
Yong-Dong
YD
Li
Institute of Diagnostic and Interventional Radiology.
Chun-Gen
CG
Wu
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Yan
Y
Su
Institute of Diagnostic and Interventional Radiology.
Hong-Mei
HM
Song
Institute of Diagnostic and Interventional Radiology.
Cheng-Jian
CJ
He
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Dong
D
Chen
malignant spinal tumor; metastasis; pain; percutaneous vertebroplasty; removal