Percutaneous vertebroplasty and bone cement perfusion at different times and temperature gradients for metastatic tumor in thoracic lumbar vertebrae / 中国组织工程研究

ABSTRACT

BACKGROUND:Percutaneous vertebroplasty has been extensively applied in treatment of osteoporotic vertebral compression fractures, and now it is also used in spinal metastatic tumor. OBJECTIVE:To evaluate the effectiveness of percutaneous vertebroplasty for metastatic tumor of thoracic lumbar vertebrae by bone cement perfusion at different times and temperature gradient. METHODS:A total of 24 cases (38 vertebrae) of metastatic tumor receiving percutaneous vertebroplasty and bone cement perfusion at different times and temperature gradient were reviewed retrospectively. Al patients were classified into group A (11 vertebrae in 9 cases) featured with apparent vertebral compression (≥ 1/4) and group B (27 vertebrae in 15 cases) of no obvious compression (<1/4). The percutaneous vertebroplasty was conducted with C-arm fluoroscopy positioning. Bone cement was injected by perfusion at different times and temperature gradient method. Visual Analogue Scales and Owestry Disability Index were recorded to assess pain al eviation and functional restoration before and after bone cement injection at different times and temperature gradient. The height of treated vertebrae was also analyzed. Fol ow-up was performed for 12 to 56 months. RESULTS AND CONCLUSION:Al 24 patients successful y underwent percutaneous vertebroplasty and bone cement perfusion at different times and temperature gradient. Bone cement (4±1) mL was averagely injected into each thoracic vertebra. Bone cement (5±1) mL was injected into each lumbar vertebra. Postoperative recheck radiographs revealed good bone cement distribution, no nerve root injury or spinal compression occurred. Vertebral height was significantly higher posttreatment compared with pretreatment in both groups (P<0.05). Visual Analogue Scales and Owestry Disability Index scores were significantly lower at 1 day, 1 month after treatment and during final fol ow-up compared with preoperation in al patients (P<0.05). No significant difference in Visual Analogue Scales and Owestry Disability Index scores was detected between two groups at the same time point. Results suggested that percutaneous vertebroplasty and bone cement perfusion at different times and temperature gradient for metastatic tumor of thoracic lumbar vertebrae could reduce the occurrence of bone cement leakage, and could ease the pain quickly for apparent and non-apparent compressed tumor metastatic vertebrae. It is an effective method to treat metastatic tumor of vertebrae.