Long-term benifts of percutaneous anatomical restoration of vertebral compression fractures linked to malignancy

David Cesar Noriega, Kruger Antonio, Ruben Hernandez Ramajo, Francisco Ardura, Marife Munoz, Soner Sahin
2015 Turkish Neurosurgery  
will develop spine symptoms, and approximately 40% to 70% of these patients will have multiple-level involvement (1, 28, 34) . The development of VCF associated with malignancy deteriorates quality of life and increases pain, sagittal imbalance and abdominal and respiratory problems (2, 41). All of these symptoms are of great importance when dealing with the osteoporotic population (18) and are even more relevant for the cancer population (13, 19, 20, 22, 33) . AIM: To evaluate the efficacy,
more » ... te the efficacy, feasibility and safety of a percutaneous anatomical vertebral body reduction for the treatment of VCF (vertebral compression fracture) linked to malignancy. Vertebroplasty and percutaneous kyphoplasty have played essential roles in the treatment of painful vertebral metastasis, although there are few reports with long survival that have evaluated the long-term efficacy, adjacent fractures and vertebral body (VB) re-collapse associated with these procedures. We aimed to evaluate the longterm efficacy and the complications associated with malignancy and changes in spinal biomechanics. MATERIAL and METHODS: The retrospective study examined 32 patients with osteolytic VCF due to malignant infiltration of the vertebral body. A visual analogue scale, the EQ5 and radiological analysis (i.e., X-ray and CT scan) were used to assess back pain, quality of life and complications. RESULTS : Statistically significant reductions in anterior and central vertebral body heights (6.2 mm-19.6 ± 4.2 mm-and 5.8 mm-16.7 ± 7.8 mm-, respectively) that resulted in reductions of the regional Cobb angles exceeding 30% were observed. There was also a statistically significant improvement in quality of life. The average survival was longer than those reported in most published articles, and the average follow-up period was 30.9 months. CONCLUSION: Anatomical restoration (i.e., cortical ring reduction with endplate rebalancing) is potentially beneficial for a wellselected group of patients with spine metastases and long life expectancies because this procedure avoids the complications typical of these types of treatments (e.g., leakage, adjacent fractures and re-collapse).
doi:10.5137/1019-5149.jtn.12294-14.1 pmid:27400110 fatcat:prbl6qch6rer5d2aqsen35y7te