Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement.

Abstract

Vertebroplasty of metastases is a minimally invasive procedure that provides immediate and long-term pain relief and contributes to spinal stabilization.

Vertebroplasty in the treatment of vertebral tumors: postprocedural outcome and quality of life

“…The results were stable over time. These data are similar to other previously reported results [4,7,8,9,13,14,23]. From our point of view, the most important finding is that 69% of nonambulatory patients became ambulatory after the PV procedure.…”

“…Procedural complications are related mostly to leakage of PMMA into adjacent structures because of vertebral cortical destruction or injection into the vertebral plexus. Several authors [8,9,23] have stated that clinically significant complications with PV occur predominantly in patients with spinal metastatic disease. These complications occur in patients with a lytic lesion affecting the posterior wall, and can result in cord compression.…”

Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine

“…The detection rate is low with fluoroscopy and radiography than that with CT [22]. Despite the high rate of PMMA leakage, extrusions of PMMA cement are usually clinically asymptomatic [7,8,25,27]. However, several reports describe the extravasation of PMMA cement into the spinal canal, where it caused severe neurologic complications including complete paralysis and incomplete paraparesis [13,17,20,23].…”

“…Initial successes were achieved in treating aggressive vertebral hemangiomas [6,10,11], painful osteolytic vertebral metastases, and myelomas [5,15,25]. Indications of PVP with PMMA have been extended to the treatment of vertebral compression fractures secondary to osteoporosis [8,9,12,16,18,19].…”

“…Among them, extravasations of PMMA cement is the most prevalent and occurs in 11-81% of PVP cases described in the literature [1,2,4,5,7,9,13,22,27]. Although extravasations of PMMA cement could be reduced by increase of the cement viscosity [3] and are usually of little clinical consequence [7,8,25,27], it can result in severe neurologic complications that require surgical decompression [7,17,[20][21][22][23][24]26].…”