Percutaneous polymethylmethacrylate vertebroplasty in the treatment of pain induced by metastatic spine tumor

Surg Neurol. 2008 Dec:70 Suppl 1:S1:78-83; discussion S1:83-4. doi: 10.1016/j.surneu.2008.08.078.

Abstract

Background: Metastases to the spine are a common problem in the large oncology center and represent a challenging problem in oncology practice. Patients with osteolytic metastases often experience intractable local and/or radicular pain. Therapeutic intervention can alleviate pain, preserve or improve neurologic function, achieve mechanical stability, and improve quality of life. Percutaneous polymethylmethacrylate vertebroplasty is an effective and relatively easy method of relieving patients' pain.

Method: Between January 2002 and December 2006, 57 patients (78 vertebrae) with spinal metastatic tumor treated with PMMA vertebroplasty were enrolled in this study. The main indication for treatment was pain.

Result: The mean value of VAS was 8.1+/-0.67 preoperatively, and it significantly decreased to 3.8+/-1.9 (1-8, P<.015) 1 day after vertebroplasty. The mean VAS value 6 months after vertebroplasty was 2.8+/-2.0 (P<.001). The mean amounts of preoperative nonnarcotic analgesic and narcotic analgesic were 1.98+/-1.4 and 1.19+/-0.73, respectively. Postoperatively, the mean amounts of nonnarcotic and narcotic analgesic decreased to 1.35+/-0.70 (P<.05) and 0.65+/-0.53 (P<.05). A statistically significant reduction of nonnarcotic analgesic use was noticed in our study.

Conclusions: Percutaneous vertebroplasty is a minimally invasive procedure that offers a remarkable advantage of effective and immediate pain relief with few complications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Bone Cements* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures*
  • Pain / drug therapy
  • Pain / etiology*
  • Pain / surgery*
  • Pain Measurement
  • Polymethyl Methacrylate* / adverse effects
  • Retrospective Studies
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / secondary*
  • Vertebroplasty / adverse effects
  • Vertebroplasty / methods*

Substances

  • Analgesics, Opioid
  • Bone Cements
  • Polymethyl Methacrylate