Importance of Percutaneous Vertebroplasty in the Management of Spinal Metastases

Abstract

Introduction: Vertebral metastases are clinically manifested by severe pain, pathologic fracture, life threatening hypercalcemia, spinal cord compression and impaired quality of life. Therapeutical strategy depends on several factors such as: life expectancy, general condition of the patient and the number of spinal lesions. Vertebroplasty techniques, especially kyphoplasty, are becoming an increasingly important option for spinal metastases. Recent studies have shown the effect of vertebroplasty on postoperative pain of metastatic origin without prolonged follow-up. The aim of our work is highlighting the short-term effect of vertebroplasty in the treatment of pain related to vertebral metastases and to study the effect on vertebral stability. Methods: We conducted a single-centered retrospective study over a period of 4 years including 30 patients affected by spinal metastases without neurological signs with a total of 46 vertebroplasties. Results: The mean age of our patients was 55.13 years. The average preoperative visual analogue scale (VAS) was 8.46 and reached an average of 2.73 maintained until the last follow-up of 2 years, attesting to the significant decrease in spinal pain (p<0.05). The average Beck index increased from 0.58 preoperatively to 0.84 postoperatively, with a significant difference (p<0.05). Angular kyphosis significantly decreased from a mean of 17.8° preoperatively to 7.3° postoperatively at the last follow-up (p<0.05). Three cases of polymethacrylate (PMMA) cement leakage were noted, with no neurological compromise. Conclusion: Spinal vertebroplasty techniques are reliable, effective and reproducible in the management of vertebral metastatic lesions, enabling stability with pain control.