Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience

척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술

Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.