Percutaneous Vertebroplasty for Pain Management in Vertebral Body Metastases. Significance and Possible Complications.

Abstract

BACKGROUND: Percutaneous vertebroplasty (PVP) and kyphoplasty are minimally invasive procedures that use polymethyl methacrylate cement injections to restore structure and shape after vertebral body metastases. They are primarily used for acute fracture mechanical pain.OBJECTIVE: The study aimed to assess the efficacy and safety of PVP in alleviating pain resulting from vertebral body metastases.METHODS: Prospectively, 40 patients had PVP for vertebral body metastases. Postoperatively, they were followed for 6 months regarding visual analogue scale (VAS) and oswestry disability index (ODI).RESULTS: The mean age was 65 years including 27 males. Prostatic cancer was the most common primary tumor in 18 (45%) patients, followed by breast cancer in 10 (25%) patients. The lumbar spine was the most affected segment, followed by the thoracic spine. Twenty-nine patients reported severe pain on the visual analogue scale (VAS). Both VAS and Oswestry disability index (ODI) significantly improved postoperatively in the 3- and 6-month follow-up. Cement leak was encountered in 4 (10%) cases; 2 (5%) cases had paravertebral muscle leak, and 2 (5%) cases had intradiscal leak.CONCLUSION: Vertebral body metastases are a disabling pathology that alter the functional capacity and result in severe pain. Percutaneous vertebroplasty significantly improves the functional capacity and pain complicating vertebral body metastases at 3- and 6-month postoperative follow-up with a high safety profile. Percutaneous vertebroplasty is recommended to restore vertebral height, especially in the absence of posterior cortical or pedicular affection.