Percutaneous vertebroplasty is safe and effective for cancer-related vertebral compression fractures.

INTRODUCTION: In cancer patients with painful vertebral fractures due to spinal metastasis, traditional pain-relieving therapies include analgesics, bed rest, steroids, radio-ther-apy, etc. These treatment modalities are often ineffective. Traditional spinal surgery in general anaesthesia is usually not an option in patients with advanced cancer and in a poor general condition. Percutaneous vertebroplasty (PVP) has been reported as a minimally invasive treatment option with apparent rapid pain relief compared with other conventional treatment options. The objective of this study was to assess the safety and efficacy of PVP in patients with malignant spinal lesions.

METHODS: From the National Danish Surgical Spine Database, DaneSpine, 30 consecutive cancer patients with vertebral fractures who underwent PVP from 2013 to 2017 were identified. From DaneSpine, the European Quality of Life - 5 Dimensions Questionnaire (EQ-5D) and the Oswestry Disability Index (ODI) scores were collected pre- and post-operatively. Data on the incidence of complications and poly-methyl methacrylate leaks were obtained by review of medical records and plain post-operative X-rays.

RESULTS: The mean improvement in EQ-5D scores from baseline was 0.30 (p < 0.01) after three months, and 0.25 (p = 0.01) after one year. The ODI improved from 44.1 to 23.3 (p < 0.01). Despite a cement leakage rate of 14.8%, no patients presented with any clinically significant symptoms.

CONCLUSIONS: PVP is a safe procedure providing a statistically significant and clinically relevant improvement in quality of life and function of patients with cancer-related vertebral compression fractures. Our findings may provide useful information to healthcare professionals who are treating cancer.

FUNDING: none.

TRIAL REGISTRATION: not relevant.