Percutaneous vertebroplasty for the treatment of painful metastatic spinal lesions of different types

Objective: To evaluate the therapeutic efficacy of percutaneous vertebroplasty (PVP) in treating osteolytic, osteoblastic, and mixed painful metastatic spinal lesions, and to discuss its complication and related technique. Methods: Single vertebra PVP was carried out in 148 patients with metastatic spinal tumor. The clinical data were retrospective analyzed. According to the preoperative CT manifestations the patients were divided into osteolytic group (n = 86), osteoblastic group (n =15) and mixed metastatic group (n = 47). The fluoroscopic time used for operation, the amount of bone cement used in procedure and the bone cement leakage were recorded. The preoperative and postoperative visual analogue scale (VAS) scores of patients in each group were determined. Results: The effective analgesic rate of the osteolytic, osteoblastic and mixed metastatic group was 81.4%(70/86), 80.0%(12/15) and 80.9%(38/47), respectively(χ² = 0.019, P = 0.991, P > 0.05). The average fluoroscopic time of the three groups was (8.5 ± 1.9) min, (14.4 ± 2.5) min and (8.3 ± 1.7) min, respectively (F = 63.073, P = 0.000, P < 0.05). The amount of bone cement used in the three groups was (3.36 ± 0.96) ml, (2.60 ± 0.89) ml and (3.23 ± 0.94) ml, respectively (F = 4.126, P = 0.018, P < 0.05). Bone cement leakage rate of the three groups was 27.9% (24/86), 20.0% (3/15) and 25.5% (12/47), respectively (χ² = 0.435, P = 0.804, P > 0.05). Conclusion: For the treatment of painful metastatic spinal lesions of different types, percutaneous vertebroplasty has satisfactory analgesic effect with fewer complications. As the manipulation of PVP in treating osteoblastic metastatic spinal lesions is relatively complicated, careful attention should be paid to the puncturing skill and the bone cement amount. (authors)