Percutaneous vertebroplasty in spinal metastases: 14 years' experience from a single centre

Purpose. To present the 14 years' experience of our centre (Pitie-Salpetriere Hospital, France) for the treatment of spinal metastases by percutaneous vertebroplasty (PV). Materials and methods. Retrospective study on 803 consecutive patients (518 female, 285 male, mean age: 58y) (2168 vertebrae) treated between January 1991 and December 2005 for spinal metastasis. All procedures were performed under fluoroscopic guidance; cement used was polymethylmetacrylate [PMMA]. Clinical follow-up was systematically assessed at 3-4 weeks. Pain evolution was evaluated on a visual analogue scale (VAS) from 0 to 10. Modification in analgesic drugs consumption and peri and post-procedure complications were systematically assessed. Results. Pain improvement was complete in 22.3% of the cases and partial in 68.9%; 8.8% of the patients remained unchanged. Opioids therapies were stopped in 18.9% of the patients. At one month follow-up, 23 patients had pain recurrence. Seven cases of cement pulmonary embolisms (confirmed on CT-scan) were observed: three were symptomatic and one lead to death. Two patients presented, secondary to a cervical vertebroplasty, a stroke episode, which lead to death in one case. Conclusion. Percutaneous vertebroplasty is an effective technique for the treatment of bone metastases. In our series, pain relief was obtained in 91% of the cases. Post-vertebroplasty morbid-mortality rate was acceptable, evaluated at respectively at 1.8 % and 0.4 % of the cases.