scholarly journals Author's Reply to the Letter to Editor, “Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension”

2017 ◽  
Vol 1 (21;1) ◽  
pp. E207-E208
Author(s):  
En-hua Xiao
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Transarterial Embolization ◽  
Vertebral Metastases

scholarly journals Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. E559-E567
Author(s):  
En-hua Xiao
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Transarterial Embolization ◽  
Univariate Analysis ◽  
Vertebral Metastases ◽  
The Third ◽  
Number Of Patients ◽  
Retrospective Clinical Study ◽  
Vas Scores ◽  
Vertebral Tumor

Background: Vertebral metastases are the most frequent vertebral tumor. Transarterial embolization (TAE) devascularizes the tumor, resulting in tumor necrosis. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, can effectively relieve tumor-related pain and improve spine stability. Unfortunately, the PVP technique is of limited use in controlling the progression of vertebral tumor, especially for paravertebral metastases. TAE combined with PVP may achieve a better control on vertebral metastases with paravertebral extension, but little information regarding the combination is available. Objectives: The present study is intended to assess the safety and effectiveness of the combination of TAE and PVP in patients suffering from vertebral metastases with paravertebral extension. Study Design: Sequential TAE followed by PVP was used in 25 patients with symptomatic vertebral metastases. The safety and effectiveness of the sequential therapy were evaluated. Setting: Three hospitals’ clinical research centers. Methods: This retrospective study was conducted with 25 consecutive patients (11 women and 14 men; mean age 59.3 years, range 38 – 80 years) with vertebral and paravertebral metastases from March 2009 to March 2014. The patients were treated with TAE, and 5 – 7 days later with the PVP procedure. The clinical outcomes were assessed by the control of pain using visual analog scale (VAS) scores, and computed tomography (CT) imaging. X2 or Fisher exact testing was performed for univariate analysis of variables. The VAS scores between groups were compared using ONEWAY ANOVA, with a P-value of less than 0.05 considered statistically significant. Results: All the TAE and PVP procedures were successfully done. Mean VAS scores decreased after TAE (from 8.64 ± 0.58 to 5.32 ± 1.46, P < 0.05) and further decreased after PVP (from 5.32 ± 1.46 to 2.36 ± 0.54, P < 0.05), and the decrease in VAS lasted until the third month (3.08 ± 1.52, P > 0.05) follow-up. However, VAS scores at the sixth month were statistically higher than those at the third month (4.8 ± 1.24 versus 3.08 ± 1.52, P < 0.05), VAS scores at the twelfth month were statistically higher than those at the sixth month (6.29 ± 1.07 versus 4.8 ± 1.24, P < 0.05). We found paravertebral cement leakage in 6 cases. No clinical or symptomatic complications were observed. In the follow-up, no patient showed further vertebral compression or spinal canal compromise. Limitations: This is a retrospective clinical study of a small number of patients. Conclusion: The sequential TAE followed by PVP is safe and effective in treating vertebral metastases with paravertebral extension. Key words: Spine, metastases, pain, embolization, vertebroplasty, interventional radiology, PVP, TAE

scholarly journals A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051983508
Author(s):  
Guan Shi ◽  
Fei Feng ◽  
Chen Hao ◽  
Jia Pu ◽  
Bao Li ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Spinal Nerve ◽  
Vertebral Compression Fractures ◽  
Vertebral Metastases ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Invasive Treatment ◽  
Compression Fractures ◽  
Cord Injury

Percutaneous vertebroplasty (PVP) is a minimally invasive treatment that has been widely used for the treatment of osteoporotic vertebral compression fractures and vertebral tumors. However, the maximum number of vertebral segments treated in a single PVP remains controversial. Furthermore, PVP may cause complications, including cement leakage, pulmonary embolism, bone cement toxicity, and spinal nerve-puncture injury. We report the rare case of a patient who underwent multilevel PVP for vertebral metastases, with no bone cement leakage or spinal cord injury, but who developed temporary paraparesis.

scholarly journals Preoperative transarterial embolization of vertebral metastases

2004 ◽  
Vol 14 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Raphael Guzman ◽  
Susan Dubach-Schwizer ◽  
Paul Heini ◽  
Karl-Olof Lovblad ◽  
Daniel Kalbermatten ◽  
...  
Keyword(s):  
Transarterial Embolization ◽  
Vertebral Metastases

scholarly journals Percutaneous Vertebroplasty in Vertebral Metastases from Breast Cancer: Interest in Terms of Pain Relief and Quality of Life

2014 ◽  
Vol 20 (5) ◽  
pp. 591-602 ◽  
Author(s):  
Héctor Manuel Barragán-Campos ◽  
Anne-Laurence Le Faou ◽  
Michèle Rose ◽  
Alain Livartowski ◽  
Marianne Doz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Pain Relief ◽  
Percutaneous Vertebroplasty ◽  
Morbidity Rate ◽  
Safe Procedure ◽  
Vertebral Metastases ◽  
Ct Guided

Percutaneous vertebroplasty (PV) is a therapeutic option in patients with vertebral metastases (VM). However its efficacy in pain relief, improvement in quality of life and safety in patients with VM from breast cancer has not been reported. We present a longitudinal retrospective study of 31 consecutively treated female patients with VM from breast cancer where 88 vertebrae were treated in 44 sessions of PV, in which osteolytic, osteoblastic and mixed lesions were recorded. The visual analogue pain scale (VAS) was used to evaluate pain pre-PV, at one, three, six and 12 months post-PV. The Eastern Cooperative Group (ECOG) performance status scale was used at the same time intervals to measure quality of life: 90.3% pain relief was identified with a VAS reduction from 5.7 ± 2.0 pre-PV to 2.9 ± 2.2 post-PV at one-month follow-up (p<0.001) and 0.6 ± 1.0 at 12-month follow-up (p<0.001). In our series 48.4% of patients were classified as having an ECOG grade 0 and 1 pre-PV, which increased to 80.8% at the 12-month follow-up. While 22.6% of the patients were classified at ECOG grades 3 and 4 pre-PV, this improved to 0% at 12 months follow-up. The morbidity rate for this procedure was 12.9% immediately and only 3.2% at 30 days post-PV with all complications being resolved medically or with CT-guided infiltration. PV is a safe procedure with a high efficacy in pain relief, and improvement of quality of life in patients with diverse types of VM from breast cancer.

scholarly journals Risk Factors for Local Bone Destruction Progression in Palliative Percutaneous Vertebroplasty for Vertebral Metastases and the Significance of Bone Cement Filling Rates

2020 ◽  
Vol 1;24 (1;1) ◽  
pp. E101-E109
Keyword(s):  
Risk Factors ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Bone Destruction ◽  
Vertebral Metastases ◽  
Filling Rate ◽  
Complete Filling ◽  
Local Bone ◽  
Group A ◽  
Group B

BACKGROUND: For palliative percutaneous vertebroplasty (PVP) for vertebral metastases, local bone destruction progression (LBDP) commonly occurs in the previously treated vertebrae. There were no studies regarding LBDP and its risk factors in previous reports, and there was no uniform evaluation method for the distribution of bone cement in the vertebrae. OBJECTIVES: We aimed to investigate the risk factors for LBDP after PVP for palliative treatments in patients with vertebral metastases. We also proposed that filling rates could be used as a simple evaluation method to detect vertebral metastases and explored its clinical significance. STUDY DESIGN: This was a retrospective study. SETTING: A university hospital. METHODS: A total of 48 patients and 54 vertebrae that had received PVP as a palliative treatment for vertebral metastases were recruited between October 2012 to October 2019 from the Shengjing Hospital of the China Medical University. We collected and evaluated the data including age, gender, cement filled completely or not, cement dose used, the cement distribution score, time of LBDP, and so on, and the filing rate we proposed was also included. RESULTS: This retrospective study divided 48 patients and 54 vertebrae into group A for those with an LBDP of less than 6 months (n = 41), and group B for those with an LBDP of 6 or more months (n = 13). The complete filling of bone cement and bone cement dose in group B was much higher than that in group A (2.85 ± 0.97 vs. 4.12 ± 1.77; P = 0.027), and the time of recurrent pain in group B was significantly higher compared with that in group A (8.46 ± 2.73 vs. 3.39 ± 1.63; P < 0.0001). There was a statistical difference in the Saliou score and filling rate between the 2 groups (11.77 ± 3.17 vs. 9.34 ± 3.28, P = 0.023; 0.752 ± 0.227 vs. 0.489 ± 0.161, P < 0.0001). Univariate logistic analysis showed that complete filling of cement, the cement dose, Saliou score, and filling rate were statistically significant predictors of LBDP occurring in less than 6 months. Multivariate logistic analysis showed that the filling rate was an independent predictor of patients with vertebral metastases developing LBDP in less than 6 months (odds ratio, < 0.001; 95% confidence interval, < 0.001–0.006; P = 0.0007). The cutoff value for the filling rate calculated from the receiver operating characteristic (ROC) curve analysis was 0.646, which could identify patients who had LBDP in less than 6 months of PVP with a sensitivity of 85.4% and specificity of 84.6%. The 6-month LBDP in the 0.646 or less ROC curve group was higher than that in the greater than 0.646 ROC curve group (97.22% vs. 55.56%, P < 0.0001). LIMITATIONS: The retrospective nature and small sample size were significant. Variation in the time and state of bone cement injected during all PVP procedures was a bias. There was no pathological diagnosis of all vertebral metastases. CONCLUSIONS: The cement dose, complete filling of cement, Saliou score, and filling rate were factors negatively related to LBDP occurring in less than 6 months. Patients with lower filling rates are maybe more likely to have early LBDP compared with those with higher filling rates. KEY WORDS: Bone cement, distribution of bone cement, local bone destruction progression, percutaneous vertebroplasty, palliative treatment, vertebral metastases

The efficacy of percutaneous vertebroplasty for palliation of pain in vertebral metastases associated with solid malignancies

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20670-e20670
Author(s):  
B. Lee ◽  
I. Franklin ◽  
C. Coombes ◽  
R. Leonard ◽  
P. Gishen ◽  
...  
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Bed Rest ◽  
Treatment Modalities ◽  
Vertebral Metastases ◽  
Solid Malignancy ◽  
Palliative Procedure ◽  
Patient Admissions ◽  
Solid Malignancies ◽  
One Year ◽  
Care Costs

e20670 Background: Painful vertebral metastases are a debilitating and common complication of a number of solid malignancies. Percutaneous vertebroplasty appears beneficial for patients with acute compression fractures of multiple aetiologies including myeloma, and osteoporosis. There are few reports on its use in the setting of metastatic solid malignancy. Methods: We identified all individuals who had undergone percutaneous vertebroplasty at our institution since 2004 and focused on those with metastatic solid malignancies. Their clinical characteristics and outcomes were investigated. Results: From 136 cases that underwent percutaneous vertebroplasties, 19 were performed mainly in breast, prostate, lung, and renal cancers. Of these 19 cases, ten patients (53%) were treated for solitary lesions, 3 (16%) were injected at two levels and the remaining 6 cases (31%) underwent cement injection at three levels. The majority of patients (84%) reported short (within 48 hours) and longer term symptomatic improvements. At a median follow up of one year, 6 patients have died. Conclusions: This study illustrates that percutaneous vertebroplasty can be a safe and beneficial palliative procedure for patients with pain related to metastatic vertebral disease. Up to three vertebral levels maybe injected at one sitting with good results. Its use can be successfully combined with other treatment modalities (radiotherapy and chemotherapy). For optimal results its use before radiotherapy has been recommended. Although it does not improve the survival outcome, palliation is a reasonable goal when life expectancy is short. Cost benefits from this procedure will come from reduced analgesic requirements and avoided complications of long-term bed rest, with significant potential savings from reduced in-patient admissions for pain control, home care costs, community nursing, and out-of ours access to clinical services. No significant financial relationships to disclose.

Results of treating vertebral metastases by percutaneous vertebroplasty combined with interventional chemotherapy

2005 ◽  
Vol 2 (4) ◽  
pp. 737-743 ◽  
Author(s):  
Hongyi Cai ◽  
Xiaohu Wang ◽  
Huiping Cao ◽  
Xiaoqi Wang ◽  
Xiaodong Liu ◽  
...  
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Vertebral Metastases ◽  
Interventional Chemotherapy
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