Percutaneous vertebroplasty combined with interventional tumor removal for malignant vertebral compression fractures with symptoms due to neurologic compression

Objective: To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) combined with interventional tumor removal (ITR) for malignant vertebral compression fractures with symptoms caused by neurologic compression. Methods: A total of 24 patients with malignant vertebral compression fractures and symptoms of neurologic compression were treated with PVP and ITR. After local anesthesia, a 14 G needle and a guidewire were inserted into the vertebral body, which was followed by sequential dilatation of the tract through the pedicle of vertebral arch by using the working cannulas until the last working cannula reached the anterior portion of the pedicle. After that, ITR was performed with a marrow nucleus rongeurs that was inserted through the working cannula. Then, 5-10 ml cement was injected into the extirpated vertebral body. The data were collected and follow-up was performed at 1-, 3-, 6-months, and yearly after the procedures. Results: PVP and ITR were successful accomplished in all patients except one, giving a technical success rate of 95.8%. The clinical assessment obtained at the final follow-up exhibited pain resolved (n = 13) and decreased (n = 7) in twenty patients with a primary clinical success rate of 87%. While full recovery (n = 9) and improved (n = 10) from neurologic compression symptoms were achieved in 19 patients with a second clinical success rate of 83%. Conclusion: For malignant compression fractures and symptoms due to neurologic compression, PVP combined with ITR is an effective treatment. (authors)