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European Radiology
Published in: European Radiology 10/2013

01-10-2013 | Interventional

Comparison of percutaneous vertebroplasty with and without interventional tumour removal for malignant vertebral compression fractures with symptoms of neurological compression

Authors: Yan Li, Yi-Feng Gu, Zhen-Kui Sun, Chun-Gen Wu, Yong-Dong Li, Wu Wang, Yuan-Chang Chen, Jing Lu

Published in: European Radiology | Issue 10/2013

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Abstract

Objective

To compare the efficacy of percutaneous vertebroplasty (PVP) with and without interventional tumor removal (ITR) on malignant vertebral compression fractures and symptoms of neurological compression.

Materials and methods

A total of 52 patients with malignant vertebral compression fractures and symptoms of neurological compression were selected for PVP and ITR (n = 24, group A) or PVP alone (n = 28, group B). A 14-G needle and a guidewire were inserted into the vertebral body, followed by sequential dilatation of the tract with the working cannula until the last working cannula reached the distal pedicle of the vertebral arch. ITR was performed with marrow nucleus rongeurs. Then, 5–10 mL cement was injected into the extirpated vertebral body.

Results

PVP procedures with and without ITR were successful in all patients, except for one patient in group A. The clinical assessment obtained at the initial and final follow-up indicated that the rates of full recovery and improved neurological compression symptoms were significantly higher in group A than in group B (P < 0.05).

Conclusion

Treatment of malignant vertebral compression fractures with symptoms of neurological compression with PVP and ITR resulted in better intermediate-term clinical results in terms of improved neurological compression symptoms than the currently recommended approach of PVP.

Key Points

• Percutaneous vertebroplasty (PVP) is now widely used for vertebral collapse due to malignancy
• PVP can be coupled with interventional tumour removal (ITR)
• PVP coupled with ITR provided better clinical results for neurological compression
• PVP coupled with ITR provided better pain relief
• PVP and ITR can remove tumour and helps prevent polymethyl methacrylate leakage
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Metadata
Title
Comparison of percutaneous vertebroplasty with and without interventional tumour removal for malignant vertebral compression fractures with symptoms of neurological compression
Authors
Yan Li
Yi-Feng Gu
Zhen-Kui Sun
Chun-Gen Wu
Yong-Dong Li
Wu Wang
Yuan-Chang Chen
Jing Lu
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2893-z

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