Clinical effectiveness of percutaneous vertebroplasty in conjunction with postoperative radiotherapy in the treatment of
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Clinical effectiveness of percutaneous vertebroplasty in conjunction with postoperative radiotherapy in the treatment of spinal metastases Miaoman Lin1 · Mingjia Qu1 · Wei Huang1 · Tao Liu1 · Ruimeng Duan1 · Yashuai Yuan1 · Junxiao Gao1 · Meng Zhang1 · Xiaobing Yu1 Received: 17 May 2020 / Accepted: 19 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose This study aimed to evaluate the clinical effects of percutaneous vertebroplasty (PVP) combined with postoperative radiotherapy (RT) in the treatment of spinal metastases. Methods Nine patients (4 males and 5 females, mean age 59.56 years) with painful pathologic compression vertebral fractures caused by metastatic cancers of the spine (5 thoracic levels, 8 lumbar levels) were admitted to our hospital between July 17, 2016 and September 25, 2018. All patients were treated with PVP via bilateral pedicle approach combined with postoperative RT to treat metastatic lesions of the centrum. The clinical records of the patients were retrospectively analyzed. Patients’ demographic features and medical conditions including the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and Imageology data were observed. Results Patients’ mean VAS scores decreased from 8.67 ± 0.50 preoperatively to 1.78 ± 0.83 at 6 months after PVP. Moreover, the mean ODI score decreased from 74.07 ± 13.15 preoperatively to 31.87 ± 10.00 at 6 months after PVP. Significant improvement in the degree of pain and dysfunction among the enrolled patients were observed. Furthermore, the metastatic carcinoma lesion within the vertebral body was well controlled according to imaging. Conclusion PVP in conjunction with postoperative RT is a good treatment strategy for vertebral compression fractures caused by metastases. Keywords Spinal metastases · SCLC · PVP · Radiotherapy · Cancer · Bone cement
Introduction The vertebral column is the most vulnerable part for malignant metastatic tumor formation in the skeletal system. Malignant metastatic tumors often result in osteolytic lesions or pathological compression fractures of the vertebral body, frequently giving rise to syndromes encompassing spinal pain, mobility disorders and sensory disturbances (Bae et al. 2016; Georgy 2008). The quality of life (QOL) and survival time among patients with metastatic tumors are less. Patients Miaoman Lin and Mingjia Qu have contributed equally to this paper. * Xiaobing Yu [email protected] 1
Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang Street, Dalian 116001, Liaoning Province, China
with spinal metastases tend to have poorer sclerotin levels and weaker physical conditions, and they generally find difficulties in tolerating traditional open surgery (Zhang et al. 2016). Additionally, since spinal metastases usually occur in multiple segments, completely removing tumors often proves difficult (Zhang et al. 2017). Thus, the aim of clinical treatment is to focus on the retention
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