What's new in vertebral cementoplasty?

Muto, Mario; Guarnieri, Gianluigi; Giurazza, Francesco; Manfrè, L.

doi:10.1259/bjr.20150337

Cited by 9 publications

(5 citation statements)

References 69 publications

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“…tRFA with concurrent vertebroplasty has shown effectiveness for vertebral lesions without spinal cord compression. Normally, RFA treatment in the spine is used for lesions located in the anterior vertebral body and far from neurovascular structures, where a conventional RF ablation straight device can easily reach the metastases [13,20]. The navigational radiofrequency ablation device differs in that it has the ability to properly curve the needle, which allows navigation of the instrument; this permits the obtaining of necrosis of tumor cells even in difficult locations of the vertebral body.…”

Section: Discussionmentioning

confidence: 99%

The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

Pusceddu¹,

Francesco

Melis

et al. 2021

Current Oncology

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Aims: The purpose of this study was to assess the effectiveness of a navigational radiofrequency ablation device with concurrent vertebral augmentation in the treatment of posterior vertebral body metastatic lesions, which are technically difficult to access. Primary outcomes of the study were evaluation of pain palliation and radiologic assessment of local tumor control. Materials and Methods: Thirty-five patients with 41 vertebral spinal metastases involving the posterior vertebral body underwent computed tomography-guided percutaneous targeted radiofrequency ablation, with a navigational radiofrequency ablation device, associated with vertebral augmentation. Twenty-one patients (60%) had 1 or 2 metastatic lesions (Group A) and fourteen (40%) patients had multiple (>2) vertebral lesions (Group B). Changes in pain severity were evaluated by visual analog scale (VAS). Metastatic lesions were evaluated in terms of radiological local control. Results: The procedure was technically successful in all the treated vertebrae. Among the symptomatic patients, the mean VAS score dropped from 5.7 (95% CI 4.9–6.5) before tRFA and to 0.9 (95% CI 0.4–1.3) after tRFA (p < 0.001). The mean decrease in VAS score between baseline and one week follow up was 4.8 (95% CI 4.2–5.4). VAS decrease over time between one week and one year following radiofrequency ablation was similar, suggesting that pain relief was immediate and durable. Neither patients with 1–2 vertebral metastases, nor those with multiple lesions, showed radiological signs of local progression or recurrence of the tumor in the index vertebrae during a median follow up of 19 months (4–46 months) and 10 months (4–37 months), respectively. Conclusion: Treatment of spinal metastases with a navigational radiofrequency ablation device and vertebral augmentation can be used to obtain local tumor control with immediate and durable pain relief, providing effective treatment in the multimodality management of difficult-to-reach spinal metastases.

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Section: Discussionmentioning

confidence: 99%

The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

Pusceddu¹,

Francesco

Melis

et al. 2021

Current Oncology

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“…Mechanism of pain relief include mechanical stabilization of oncological vertebral fractures, direct chemical and thermic effect of the cement on the vertebral body's nerve [21,22]. Moreover bone cement provide durable local tumor suppression [23].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty of malignant lesions of the thoracolumbar spine: analysis of treatment results

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. The pathological vertebral compression fracture (VCF) in course of cancer range from 5 to 39% among oncological patients. Main symptom is a back pain, that is refractory to medical therapy. Treatment of stable pathological VCF include radiotherapy, bisphosphonate medication and bracing. Nonoperative modalities are effective in pain management. However their results are delayed or require immobilization of patient. Additional they influence on the spine stability is small. Instabile VCF led to progressive kyphotic deformation, that reduce lung capacity, physical and social function of patient and decreased quality of life. Vertebroplasty (VP) is mini-invasive surgical technique of the vertebral body augmentation with methyl methacrylate. The first percutaneous vertebroplasty was performed in 1984 be Galibert since then VP prove to be effective in treatment of VCF. Material and methods. Retrospective analysis of 72 patients with solid tumor metastasis and myeloma multiplex which underwent VP in the Oncological Orthopedic Department of the Podkarpackie Oncological Center were made. Patients were operated since 2015 to 2016. Mean age of study population were 60.4 ± 12.6 years. The amount of cement which was injected was 3.98 ± 1.5 ml. The procedure last on average 22 ± 5 minute. The most common primary tumor type was breast cancer and myeloma multiplex. Results. Over 100 levels in 72 patients were stabilized with VP. In 69% one level was augmented. Mean VAS reduction was 3.98 ± 1.56 point and Karnofsky score increase of 11.2 ± 4.3 point. Effectiveness of VP was independent from site of primary tumor, Tomita score, localization, and number of metastasis, and amount of injected cement. Patients with myeloma multiplex had smaller reduction of VAS compare to solid tumor group and require additional procedure at different level. In postoperative period in 42% case asymptomatic cement leakage occur. In one case (1.4%) leakage to the spinal canal was noted and laminotomy was required. Conclusions. Vertebroplasty is effective noninvasive technique for pain reduction in patients with pathological compression fracture of the vertebral body. Patients with myeloma multiplex had lower VAS reduction and are more likely to need second VP at different level. The most common complication is cement leakage which is asymptomatic.

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“…Percutaneous mini-invasive treatments were developed to improve the quality of life of patients affected by stable VCF or type A1-A3 Magerl's classification fractures as antalgic and vertebral augmentation treatments. 15 The goal of the treatment is to improve clinical outcomes based on a quick recovery of mobility and prevention of pathologic collapse and deformity of the spinal column.…”

Section: Vertebral Treatmentmentioning

confidence: 99%

Percutaneous Treatment of Vertebral Fractures

Muto

Giurazza

Guarnieri

et al. 2017

Semin Musculoskelet Radiol

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The thoracolumbar junction and lumbosacral segment are the portions of the spinal column most prone to acute traumatic fractures. Multiple classifications and injury severity score systems have been published to standardize the management of patients, establishing stable/unstable and surgical/nonsurgical fractures. In the past, patients could be treated only by surgical stabilization or conservative methods. The latter implied bed rest, long immobilization periods, prolonged drugs therapies, and, at worst, the evolution of kyphosis. Percutaneous mini-invasive treatments have been developed to improve the quality of life of patients affected by stable fractures, by rapidly recovering mobility and preventing deformity of the spinal column. These approaches, based on assisted techniques, imply the placement of different types of expandable bone implant systems. We discuss the treatment of vertebral fractures, focusing on percutaneous procedures and analyzing indications, contraindications, and outcomes of patients affected by vertebral nonosteoporotic/nonneoplastic but traumatic fractures.

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What's new in vertebral cementoplasty?

Cited by 9 publications

References 69 publications

The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

Percutaneous Vertebroplasty of malignant lesions of the thoracolumbar spine: analysis of treatment results

Percutaneous Treatment of Vertebral Fractures

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