Safety and efficacy of multilevel vertebroplasty for painful osteolytic spinal metastases: a single-centre experience

Eur Radiol. 2017 Aug;27(8):3436-3442. doi: 10.1007/s00330-016-4683-x. Epub 2016 Dec 14.

Abstract

Objective: To retrospectively assess the safety and efficacy of percutaneous vertebroplasty (PVP) for painful osteolytic spinal metastases when treating more than three vertebrae per session.

Methods: A total of 153 patients with painful osteolytic spinal metastases underwent PVP. Group A patients (n = 93) underwent PVP at up to three vertebral levels per session. Group B patients (n = 60) underwent PVP at more than three levels in one session. Pain, quality of life (QoL), and mobility were assessed before and after PVP. Minor and major complications were systematically assessed.

Results: Both groups experienced significant pain relief and QoL improvement after the intervention (p < 0.001). Mobility improvement was observed in both groups, despite worse mobility status before PVP in group B compared with group A. There was no significant difference between the two groups throughout the follow-up period in overall pain relief and improvement in QoL and mobility. There was also no significant difference between groups in minor and major complications.

Conclusions: Multilevel vertebroplasty is safe and effective for the treatment of multiple osteolytic spinal metastases. Multilevel PVP relieves pain and improves QoL and mobility.

Key points: • Percutaneous vertebroplasty is safe and effective for painful osteolytic spinal metastases. • Multilevel vertebroplasty does not cause more complications than single-level vertebroplasty. • Multiple spinal metastases patients may regain functional independence after multilevel vertebroplasty.

Keywords: Malignant; Multilevel; Pain; Percutaneous vertebroplasty; Spinal neoplasms.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Back Pain / diagnostic imaging
  • Back Pain / etiology
  • Back Pain / surgery
  • Female
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Osteolysis / diagnostic imaging
  • Osteolysis / etiology
  • Osteolysis / surgery*
  • Pain Management / methods
  • Pain Measurement / methods
  • Quality of Life
  • Retrospective Studies
  • Spinal Fractures / etiology
  • Spinal Fractures / surgery
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / secondary*
  • Spinal Neoplasms / surgery*
  • Tomography, X-Ray Computed
  • Vertebroplasty / adverse effects*
  • Vertebroplasty / methods