ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical application and therapeutic effect of percutaneous vertebroplasty(PVP) and open vertebroplasty for metastatic spinal tumor.</p><p><b>METHODS</b>The clinical data of 126 patients with metastatic spinal tumor underwent surgery and obtained follow-up from January 2012 to March 2016 were retrospectively analyzed. These 126 cases were divided into two groups according to different operative methods. The metastatic tumor of 43 cases encroached vertebral canal oppressing spinal cord and nerve root, they were treated with open operation(open vertebroplasty group);and other 83 cases without obviously spinal cord or nerve root compression, or unfit for open operation, were treated with PVP (percutaneous vertebroplasty group) . VAS score, ECOG and Frankel grade were used to evaluate the pain and neurofunction in two groups.All out-hospital patients were followed up every 3 months for 1 time. X-ray, CT, MRI were examined in follow-up.</p><p><b>RESULTS</b>A total of 112 vertebrae underwent PVP with the median surgical time of 50 min;VAS scores decreased significantly at 2 days after operation, which maintained till 1 month later; ECOG grade at 1 month decreased significantly;44 of 112 vertebrae suffered from asymptomatic bone cement leakage, no complications such as nerve injury or pulmonary embolism was found; the median survival time was 16 months. While for open vertebroplasty group, the median surgical time was 160 min and blood loss was 1 000 ml; postoperative VAS scores and ECOG grade at 1 month decreased significantly. Postoperative Frankel grade of 36 patients got improvement in 41 patients with spinal cord functional disturbance(87.8%); and 29 of 40 patients with incompleteness out of motor function were full recovery(76.3%); 12 cases (27.9%) occurred complications and the median survival time was 11 months.</p><p><b>CONCLUSIONS</b>The different vertebroplasty treatments can be selected for patients with metastatic spinal tumor, which can relieve the pain, improve the nerve function, reconstruct the spinal stabilization, maintain the local control and raise the life quality.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To investigate clinical outcome of surgical treatment for spinal metastatic tumors.</p><p><b>METHODS</b>Thirty-six patients with metastatic spine tumors treated surgically were retrospectivly reviewed from September 2005 to August 2010. There were 15 males and 21 females with an average age of 58 years old (ranged, 27 to 79 years). The site of origin of primary cancer included the breast, prostate, colon, lung, liver, esophagus, kidney, carcinoma, bladder, and 10 patients were with unidentified primary cancer. Five lesions were located in the cervical spine, 17 in the thoracic spine, 13 in the lumbar spine and 1 in the sacral vertebrae. Preoperative evaluation was conducted according to Tokuhashi system: total score 0 to 8 in 9 cases, 9 to 11 in 25 cases, 12 to 15 in 2 cases. The surgical procedures, including PVP, tumor resection and decompression, titanium nets implant, artificial vertebra replacement, bone cement stuffiness and inter fixation, were performed based on Tokuhashi score, location of lesions and neurological symptoms.</p><p><b>RESULTS</b>All the patients were followed up, and the during ranged from 2 months to 60 months with a mean time of 10.8 months. Pain relief was obtained in all patients after operation, and the VAS pain scores declined after operation. Among 14 patients suffering from spinal cord and nerve compromise, 12 patients improved 1 to 2 grades after surgery according to the Frankel grading system. According to the system of the ECOG performance status: 28 patients improved 1 to 2 grades in performance status after surgery. The postoperative survival rates at 3 months, 6 months, 1 year and 2 years were 97.2%, 63.9%, 38.9% and 16.7% respectively. Six patines had bone cement leakage after PVP, and none resulted in severe complications.</p><p><b>CONCLUSION</b>According to single or multiple spinal metastases, neurological symptoms, spinal stability and patients' condition, the different surgical treatments can be selected for spinal metastatic patients, which can relieve pain, maintain or improve the neurological status, improve quality of life, improve survival rate of patients.</p>