Vertebroplasty shows no antitumoral effect on vertebral metastasis: a case-based study on anatomopathological examinations

Balestrino, Alberto; Boriani, Stefano; Cecchinato, Riccardo; Parafioriti, Antonina; Gambarotti, Marco; Gasbarrini, A.

doi:10.1007/s00586-020-06555-9

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…3) The heat production and release of chemically toxic substances during the solidification of PMMA are performed to kill tumor cells [24] , [25] , [26] . However, some studies have concluded that PVP has weak anti-tumor effects, and a study recently suggested that it does not have tumoricidal effects [27] . Therefore, the anti-tumor effect of PMMA needs to be further verified through animal studies or in vitro experiments.…”

Section: Commonly Used Minimally Invasive Treatment Methodsmentioning

confidence: 99%

“…Another study concluded that POP has a weak antitumor effect and that PMMA infusion increases the risk of cancer cells entering the circulation within minutes after injection. So, ablation can be performed before cement infusion to obtain better local tumor control [27] , [30] , [31] . Levy [31] conducted a multicenter study that included 100 cases, 97 of which were treated with cementoplasty combined with radiofrequency ablation therapy.…”

Section: Commonly Used Minimally Invasive Treatment Methodsmentioning

confidence: 99%

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State-of-the-art of minimally invasive treatments of bone metastases

Chang

et al. 2022

Journal of Bone Oncology

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Section: Commonly Used Minimally Invasive Treatment Methodsmentioning

confidence: 99%

Section: Commonly Used Minimally Invasive Treatment Methodsmentioning

confidence: 99%

State-of-the-art of minimally invasive treatments of bone metastases

Chang

et al. 2022

Journal of Bone Oncology

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“…Ein anti-neoplastischer Effekt der Injektion von PMMA im Rahmen der Vertebrobzw. Kyphoplastie konnte bisher nicht bestätigt werden [16]. Es gibt in der Literatur jedoch Hinweise darauf, dass bei der Kyphoplastie Tumorzellen aus der Wirbelkörpermetastase in die Blutbahn gelangen [17].…”

Section: Wirbelkörperaugmentation Mit Knochenzementunclassified

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Osterhoff,

Heyde

2023

Die Wirbelsäule

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ZusammenfassungDie Wirbelsäule ist nach Leber und Lunge einer der wichtigsten Manifestationsorte für metastasierende Tumor-Erkrankungen. Metastasen der Wirbelsäule können zu Schmerzen, neurologischen Ausfällen und eingeschränkter Lebensqualität führen. Die Augmentation der befallenen Wirbelkörper mit Knochenzement hat sich als wirksame Behandlungsoption zur Schmerzbehandlung, Stabilisierung und Verbesserung der funktionellen Ergebnisse bei Patienten erwiesen. Weitere Anwendungen von Knochenzement in der Tumorchirurgie der Wirbelsäule sind die Augmentation von Pedikelschrauben und der Wirbelkörperersatz, selten auch bei der operativen Behandlung von Primärtumoren.Ziel dieser Übersichtsarbeit ist es, einen umfassenden Überblick über die aktuelle Evidenz zur Verwendung von Knochenzement in der Tumorchirurgie der Wirbelsäule zu geben, einschließlich Indikationen, Techniken, Ergebnissen und potenziellen Komplikationen.

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“…10 Recently a clinical study has shown that after vertebroplasty there was not anatomopathological evidence of cement-induced tumor necrosis. 11…”

Section: Introductionmentioning

confidence: 99%

“…10 Recently a clinical study has shown that after vertebroplasty there was not anatomopathological evidence of cement-induced tumor necrosis. 11 One characteristic of PMMA is the capability of drug diffusion. Since the 1970s, antibiotics have been added to PMMA to treat bone infections.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome and Histological Findings After Induced Leakage of PMMA Loaded With Methotrexate and Cisplatin During Vertebroplasty: Experimental Model in Pigs

González

Llombart-Blanco

Ángulo

et al. 2021

Global Spine Journal

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Study Design: Animal experimental model. Objective: To study the clinical behavior and histological changes in the spinal cord, nerve roots and perivertebral muscles of the spine after induced leakage of polymethylmethacrylate (PMMA) loaded with antiblastic drugs during vertebroplasty in an animal model of pigs. Methods: We performed vertebroplasty on 25 pigs. The animals were divided into 3 groups: vertebroplasty with PMMA alone (control group), vertebroplasty with PMMA loaded with methotrexate (MTX) and vertebroplasty with PMMA loaded with cisplatin (CYS). At 2 vertebral levels, epidural and prevertebral, massive cement leaks were induced. Animals were evaluated daily. Two weeks later, the pigs were sacrificed, and the tissues that came in contact with the cement were analyzed. Results: The clinical results for each of the groups were reported. The control group had no clinical alterations. In the MTX group, 2 pigs died before 1 week due to pneumonitis. In the CYS group, 4 animals had motor impairment, and 3 of the 4 had paraplegia. The histological results were as follows: the control and MTX groups showed synovial metaplasia, inflammatory reaction, crystal deposits, and giant cell reaction in the dura mater and muscle and all the animals in the CYS group had spinal cord and muscular necrosis. Conclusions: Massive cement leak after vertebroplasty with PMMA loaded with cisplatin is extremely toxic to the spinal cord and muscles around the spine. Therefore, its use cannot be recommended for the treatment of vertebral metastases. Using PMMA loaded with methotrexate seems to be a safe procedure, but further research is needed.

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Vertebroplasty shows no antitumoral effect on vertebral metastasis: a case-based study on anatomopathological examinations

Cited by 6 publications

References 20 publications

State-of-the-art of minimally invasive treatments of bone metastases

State-of-the-art of minimally invasive treatments of bone metastases

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Clinical Outcome and Histological Findings After Induced Leakage of PMMA Loaded With Methotrexate and Cisplatin During Vertebroplasty: Experimental Model in Pigs

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