Preoperative Motion-Related Pain in Cancer Patients with Extraspinal Metastases Treated by Percutaneous Osteoplasty

Abstract

Purpose: Percutaneous osteoplasty (POP) as a technical extension of percutaneous vertebroplasty (PVP) has been used as a treatment for painful extraspinal metastatic lesions besides the vertebrae. PVPs are performed in weight-bearing vertebrae; extraspinal POPs are usually performed in non-weight-bearing flat bones. Pain on extraspinal lesions may not be provoked by weight-bearing position but be provoked by specific motion. This study was performed to evaluate patient motion-related pain (MRP) and the resulting pain-related impairment (PRI) by specific motion according to the involved sites where extraspinal POP was performed. Methods:We performed a retrospective study that evaluated the MRP and resultant PRI by reviewing the charts of 66 patients treated with 70 extraspinal POPs. The numeric rating scale (NRS) scores in 5 different positions including while lying on the back, lying on the affected side, sitting, standing, and walking and the Karnofsky performance scale (KPS) scores before and after POP were used to evaluate MRP and PRI, respectively. Results:The postoperative mean NRS scores became significantly lower when patients were in specific 1 of the 5 positions: lying on their affected side following scapuloplasty; sitting following ischioplasty; lying on their affected side in ilioplasty; and lying on their affected side following costoplasty. The mean KPS scores in all patients became higher after POP. Conclusions:The characteristic preoperative MRP and the resulting PRI according to the involved sites in cancer patients with extraspinal metastases developed by specific motion and alleviated pain and impairment by POP, if the cancer did not involve the joints.