Clinical application of percutaneous vertebroplasty in treating osteoblastic spinal metastases / 介入放射学杂志

Objective To discuss the feasibility and short-term clinical effectiveness of DSA-guided percutaneous vertebroplasty (PVP) for the treatment of painful osteoblastic metastatic spinal lesions. Methods During the period from Jan. 2010 to Dec. 2011 at authors’ hospital PVP was carried out in 23 patients with osteoblastic spinal metastases (34 lesions in total). Coexisting osteoblastic pathological fracture was found in twelve patients. The WHO standards, visual analogue scale (VAS) and karnofsky-KPS score were used to evaluate the therapeutic results. Results Technical success was achieved in all patients. All patients were followed up for at least 3 months. Of 20 patients who had complete clinical data, complete remission (CR) was obtained in 6, partial remission (PR) in 10, mild remission (MR) in 3 and no remission (NR) in one. The clinical effectiveness (CR+PR) was 80%. The mean VAS scores dropped from preoperative (7.0 ± 1.6) to (2.2 ± 1.9) at 24 hours after the treatment, and to (2.4 ± 2.1) and (2.5 ± 2.1) at one and three months after the treatment respectively. The mean KPS scores rose from preoperative (76.5 ± 10.4) to (86.5 ± 11.8), (88.0 ± 12.0) and (89.0 ± 10.8) at 24 hours and one, three months after the treatment respectively. Small amount leakage of PMMA was observed in 4 cases (17.4%) with no obvious clinical symptoms. Conclusion DSA-guided PVP is a feasible and effective treatment for painful osteoblastic spinal metastases. This therapy can immediately relieve pain and reinforce spine, besides, it can remarkably improve the living quality and decrease the incidence of paraplegia.

An Unusual Case of Osteoblastic Metastasis from Gastric Carcinoma

We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.

An Unusual Case of Osteoblastic Metastasis from Gastric Carcinoma

We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.