Efficacy of percutaneous vertebroplasty for the relief of osteoblastic spinal metastasis pain

The aim of the present manuscript was to retrospectively evaluate the efficacy of fluoroscopy-guided percutaneous vertebroplasty (PVP) for the relief of osteoblastic spinal metastases pain. PVP was performed in 39 consecutive patients with 82 osteoblastic metastatic spinal vertebras. 19 vertebras had pathologic compressive fracture and the other 63 vertebras had no compressive fracture with obvious imaging abnormalities. The ages of the patients ranged from 40 to 77 years with a mean age of 58.5 +/- 9.0 years. Visual analog scale (VAS) and QLQ-BM22 score were used to evaluate pain and quality of life at 2 days pre-operation and at 1 week and 3 months post-operation. Among all 82 vertebras, 35 vertebras had been injected bilaterally and the other 47 vertebras unilaterally. The amount of cement injected per lesion ranged from 0.5 to 4.5 ml with a mean volume of 1.6 +/- 0.8 ml. Cement deposition in all lesions was uniform. The patients were followed up from 3 to 15.5 months with a mean follow up time of 5.6 +/- 3.4 months. Mean VAS score declined significantly from preoperative 4.3 +/- 2.4 to postoperative 3.0 +/- 1.7 at 1 week and 2.4 +/- 2.0 at 3 months after the procedure (P=0.001). Mean QLQ-BM22 score declined significantly from preoperative 49.1 +/- 12.3 to postoperative 42.4 +/- 9.5 at 1 week and 39.6 +/- 10.4 at 3 months after the procedure (P<0.001). Extraosseous cement leakage occurred in 21 vertebras of 13 cases and in 1 case into the thoracic vertebra canal without causing any clinical complications. No further procedures were performed after leakage. PVP is an effective treatment for painful osteoblastic spinal metastases. It can relieve pain, reduce disability and improve function. The main complications are bone cement leakage and incomplete pain relief.