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Percutaneous vertebroplasty and interventional tumor removal for malignant vertebral compression fractures and/or spinal metastatic tumor with epidural involvement: a prospective pilot study

Authors Gu YF, Tian QH, Li YD, Wu CG, Su Y, Song HM, He CJ, Chen D

Received 13 September 2016

Accepted for publication 6 December 2016

Published 20 January 2017 Volume 2017:10 Pages 211—218

DOI https://doi.org/10.2147/JPR.S122211

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Enrica Santarcangelo

Yi-Feng Gu,1 Qing-Hua Tian,1 Yong-Dong Li,1 Chun-Gen Wu,1 Yan Su,2 Hong-Mei Song,1 Cheng-Jian He,1 Dong Chen,2

1Institute of Diagnostic and Interventional Radiology, 2Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China

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.
Patients and 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).
Conclusion: 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.

Keywords: percutaneous vertebroplasty, pain, malignant spinal tumor, removal, metastasis

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