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Murotani K, Fujibayashi S, Otsuki B, Shimizu T, Sono T, Onishi E, Kimura H, Tamaki Y, Tsubouchi N, Ota M, Tsutsumi R, Ishibe T, Matsuda S. Prognostic Factors after Surgical Treatment for Spinal Metastases. Asian Spine J 2024; 18:390-397. [PMID: 38764228 PMCID: PMC11222892 DOI: 10.31616/asj.2023.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/01/2024] [Accepted: 02/16/2024] [Indexed: 05/21/2024] Open
Abstract
STUDY DESIGN A retrospective multicenter case series was conducted. PURPOSE This study aimed to investigate survival and prognostic factors after surgery for a metastatic spinal tumor. OVERVIEW OF LITERATURE Prognostic factors after spinal metastasis surgery remain controversial. METHODS A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model. RESULTS The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23-10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10-5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72-12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15-0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26-0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14-0.32; p<0.01) were suggested to improve survival. CONCLUSIONS Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.
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Affiliation(s)
- Kazuhiro Murotani
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Bungo Otsuki
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayoshi Shimizu
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Sono
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eijiro Onishi
- Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Amagasaki General Medical Center, Hyogo, Japan
| | - Yasuyuki Tamaki
- Department of Orthopaedic Surgery, Wakayama Red Cross Hospital, Wakayama, Japan
| | - Naoya Tsubouchi
- Department of Orthopaedic Surgery, Kyoto Medical Center, Kyoto, Japan
| | - Masato Ota
- Department of Orthopaedic Surgery, Kitano Hospital, Osaka, Japan
| | - Ryosuke Tsutsumi
- Department of Orthopaedic Surgery, Osaka Red-Cross Hospital, Osaka, Japan
| | - Tatsuya Ishibe
- Shiga Spine Center, Hino Memorial Hospital, Shiga, Japan
| | - Shuichi Matsuda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Palma D, Thakur N, Loy JC, Margulies BS. Treating bone metastases with local therapy in a breast cancer patient resulted in decreased pain and prevented fracture. Pain Manag 2023; 13:569-577. [PMID: 37795710 DOI: 10.2217/pmt-2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
Lytic lesions from bone metastases from breast, lung and prostate carcinomas, are associated with a poor prognosis and significant morbidities that include fracture and debilitating pain. Chemotherapeutics, palliative radiation therapy and surgical intervention are routinely used to treat these lesions. The ZetaMet™ Bone Graft is a novel antitumorigenic and osteoinductive graft that offers a potential alternative treatment option. ZetaMet is composed of calcium phosphate salts, type-I collagen and the small molecule N-allyl noroxymorphone dihydrate. Here, we report the case of a stage IV breast cancer patient with multiple lytic metastatic lesions to the spine that were successfully treated, which led to a significant reduction in pain and increased quality of life. This outcome demonstrates that a locally administered therapeutic intervention may represent an important alternative for patients with bone metastases that warrants further study.
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Affiliation(s)
- David Palma
- Mobility Bone & Joint Institute, Andover, MA 01810, USA
| | - Nikhil Thakur
- Mobility Bone & Joint Institute, Andover, MA 01810, USA
- Zetagen Therapeutics, Syracuse, NY 13210, USA
| | - Joe C Loy
- Zetagen Therapeutics, Syracuse, NY 13210, USA
| | - Bryan S Margulies
- Zetagen Therapeutics, Syracuse, NY 13210, USA
- Department of Pathology, College of Medicine, Upstate Medical University, Syracuse, NY 13210, USA
- Department Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
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Wu W, Zhang X, Li X, Yu S. The influence of diverse bone cement distribution patterns for metastatic vertebral lesions after bilateral percutaneous kyphoplasty. BMC Musculoskelet Disord 2022; 23:713. [PMID: 35883056 PMCID: PMC9316733 DOI: 10.1186/s12891-022-05680-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the influence of diverse bone cement distribution patterns in patients with metastatic vertebral lesions after bilateral percutaneous kyphoplasty (PKP). Methods Fifty-nine patients with single-level metastatic vertebral lesions who received bilateral PKP were retrospectively reviewed. According to the different bone cement distribution patterns, patients were divided into confluent (n = 35, CF) and separated (n = 24, SP) groups. Indicators including visual analogue scale (VAS), Oswestry Disability Index (ODI), vertebral body height (VBH) variation, quality of life (QoL), and related complications were reviewed and compared between the two groups. Results No statistically significant differences were observed between the two groups in age, sex, types of lesions, locations of lesions, posterior vertebral body and/or pedicle involvement, percentage of vertebral invasion, procedure duration or cement volume (p > 0.05). There was significant improvement in VAS, ODI, VBH and QoL at any follow-up examination (p < 0.05) compared with those preoperatively. The CF group exhibited better pain relief in VAS scores than did the SP group just at 3 days and 1 month after PKP (p < 0.05). There were no significant differences between the two groups in VAS scores at 3 months or 1 year after PKP (p > 0.05). No statistically significant differences were observed between the two groups in terms of ODI, VBH or QoL (p > 0.05). There was no statistically significant difference in the incidence of complications between the two groups (p > 0.05). Conclusions More rapid pain relief was achieved with confluent rather than separated bone cement distribution patterns in PKP for patients with metastatic vertebral lesions.
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Affiliation(s)
- Wence Wu
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xinxin Zhang
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xiaoyang Li
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shengji Yu
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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Cornelis FH, Barral M, Le Huec JC, Deschamps F, De Baere T, Tselikas L. Percutaneous Transpedicular Fixation by PEEK Polymer Implants Combined with Cementoplasty for Vertebral Compression Fractures: A Pilot Study. Cardiovasc Intervent Radiol 2021; 44:642-646. [PMID: 33388874 DOI: 10.1007/s00270-020-02719-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the feasibility and safety of percutaneous transpedicular fixation by PEEK polymer implants and cementoplasty for vertebral compression fracture (VCF). MATERIALS AND METHODS From February 2019 to December 2019, 6 consecutive patients (3 men and 3 women; mean age 55 ± 8 years; range 40-64 years) who had percutaneous transpedicular fixation with cementoplasty for the treatment of VCF (5 tumor lesions, 1 traumatic) were included. The procedure duration, length of hospital stay, and complications were reported. Visual analog scale (VAS) and the Oswestry disability index (ODI) for pain and disability were assessed before and 2 months after the procedure. RESULTS The mean procedure duration was 74 ± 47 min (range 20-140 min). The median length of hospital stay was 3 days (range 2-63) after the procedure. Only minor adverse events were reported (4 asymptomatic cement leakages) but no severe complications. No cases of procedural site fracture during follow-up were noted (median 198 days; range 78-238 days). The mean VAS score decreased from 6.2 ± 1.8 mm (median 6 mm; range 4-9 mm) before the procedure to 1.7 ± 2.1 mm (median 1; range 0-5 mm) after the procedure. The ODI decreased from 36 ± 14% (range 18-54%) before the procedure to 23 ± 10% (range 11-30%) at 2-months follow-up. CONCLUSIONS Percutaneous transpedicular fixation of VCF by PEEK implants with cementoplasty appears feasible and safe.
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Affiliation(s)
- F H Cornelis
- Department of Interventional Radiology, Tenon Hospital, APHP.Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
| | - M Barral
- Department of Interventional Radiology, Tenon Hospital, APHP.Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
| | - J C Le Huec
- Polyclinique Bordeaux Nord Aquitaine, Institut Européen du Dos - VERTEBRA, 15 Rue Claude Boucher, 33000, Bordeaux, France
| | - F Deschamps
- Department of Interventional Radiology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - T De Baere
- Department of Interventional Radiology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - L Tselikas
- Department of Interventional Radiology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
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How do vertebroplasty and kyphoplasty affect the quality of life of patients with multiple myeloma spinal metastasis? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2020; 30:1447-1451. [PMID: 32591912 DOI: 10.1007/s00590-020-02721-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metastatic spinal lesions are diseases that impair the quality of life and require early diagnosis and treatment. The count of spinal metastasis patients rises day by day. Increased life expectancy has increased the incidence of cancer, making metastases more observable. The aim of our study was to investigate how the quality of life is affected in the patient group with vertebral fracture due to spinal metastases of multiple myeloma and undergoing vertebroplasty and kyphoplasty. MATERIALS AND METHODS Forty-two patients with fracture due to spinal metastasis and adequate follow-up between the years of 2011 and 2018 were included in the study. Patients were listed according to their primary malignancy and metastases. The effect of vertebroplasty and kyphoplasty was investigated by evaluating preoperative and postoperative VAS and Oswestry Disability Index scores. All patients' radiographic kyphosis angle, compression ratio and wedging index were calculated before operation and after operation. RESULTS A total of 76 vertebrae were operated in 42 patients. Significant differences were found in the comparison of preoperative and postoperative quality of life according to VAS and Oswestry Disability Index scores in the patients undergoing vertebroplasty, kyphoplasty or both procedures after spinal metastases (VAS; p = 0.0001, ODI; p = 0.002/0.0001). There were statistically significant differences in preoperative local kyphosis angle, compression ratio and wedging index and post-op local kyphosis angle, compression ratio and wedging index (p = 0.001). CONCLUSION Vertebroplasty and kyphoplasty, minimally invasive procedures performed after spinal metastases, improve the quality of life of the patients.
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He S, Zhou Z, Zhang C, Lv N, Qian Z, Sun Z. Kyphoplasty in the treatment of occult and non-occult metastatic vertebral tumors. Medicine (Baltimore) 2020; 99:e20430. [PMID: 32569166 PMCID: PMC7310909 DOI: 10.1097/md.0000000000020430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
To compare the efficacy and safety of kyphoplasty (KP) in the treatment of occult metastatic vertebral tumors (OMVT) and non-occult metastatic vertebral tumors (MVT).From January 2013 to December 2017, 65 cases of occult metastatic vertebral tumors and 82 cases of metastatic vertebral tumors were selected and divided into 2 groups. After KP, they were followed up by a year of outpatient visits and telephone calls. The visual analogue scale (VAS) and Oswestry disability index (ODI) scores, the amount of bone cement injected, the change of vertebral height and the incidence of complications were recorded, compared and analyzed by SPSS software. t test was used to compare the differences between the same group of patients at different times and between the 2 groups of patients.In the OMVT group, the operation time was 24.52 ± 4.24 minutes, the fluoroscopy time was 10.18 ± 1.53 minutes and the volume of bone cement was 3.62 ± 0.93 ml. The VAS score decreased from 7.26 ± 01.08 preoperatively to 2.77 ± 0.93 postoperatively (P < .01). The ODI score decreased from 64.89 ± 9.05 preoperatively to 25.82 ± 4.63 postoperatively (P < .01). In the MVT group, the operation time was 26.63 ± 4.61 minutes, the fluoroscopy time was 11.04 ± 2.15 minutes and the volume of bone cement was 4.09 ± 1.10 ml. The VAS score decreased from 7.73 ± 0.94 preoperatively to 3.22 ± 0.80 postoperatively (P < .01). The ODI score decreased from 69.20 ± 7.14 preoperatively to 28.02 ± 4.40 postoperatively (P < .01). The vertebral height of MVT patients was significantly improved after operation (P < .01), but there was no difference in OMVT patients (P > .05).Occult metastatic vertebral tumors can be detected by Magnetic Resonance Imaging (MRI), and KP may be more effective and safer in the treatment of OMVT.
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Affiliation(s)
- Shuangjun He
- Department of Orthopedic Surgery, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, Jiangsu Province
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou
| | - Zhangzhe Zhou
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou
| | - Changhao Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou
| | - Nanning Lv
- Department of Orthopedic Surgery, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Zhonglai Qian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou
| | - Zhiyong Sun
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou
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CORTEZ PAULOROGÉRIO. SPINAL METASTASIS: DIAGNOSIS, TREATMENT AND PROGNOSIS - INTEGRATIVE REVIEW FROM 2012 TO 2017. COLUNA/COLUMNA 2020. [DOI: 10.1590/s1808-185120201901192641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
ABSTRACT Care of the patient with spinal metastasis is challenging. The topic of this article is the treatment and prognosis of spinal metastases, aiming to enumerate and analyze literature that addresses this treatment and prognosis. The methodology used was an integrative review in the Virtual Health Library. Nineteen articles were identified demonstrating that there is research and scientific production in this area. The thematic units and their categories are: treatment decision - prognostic scales or clinical neurological evaluation; types of treatment - minimally invasive and/or traditional; and effectiveness of prognostic scales higher or lower probability of success, which provide insight into the different possibilities of patient evaluation and their applicability in practice. When making the diagnosis, planning the treatment, and establishing a prognosis, the professional must be in sync with current precepts and act based on the objective and subjective characteristics of the patients, such as beliefs and values, which although immeasurable, influence the survival and the effectiveness of treatment. Level of evidence I; Integrative Review.
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Affiliation(s)
- PAULO ROGÉRIO CORTEZ
- Universidade Federal Fluminense, Brazil; Hospital Estadual Azevedo Lima, Brazil; Hospital Federal do Andaraí, Brazil; Centro de Saúde da Coluna, Brazil
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Zhou Z, Wang Y, Sun Z, Qian Z. Safety of Cement Distribution Patterns in Metastatic Vertebral Tumors: A Retrospective Study. Med Sci Monit 2019; 25:7228-7234. [PMID: 31556404 PMCID: PMC6777383 DOI: 10.12659/msm.918212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Kyphoplasty (KP) is a palliative treatment for patients with metastatic vertebral tumors. The distribution pattern of cement affects safety and efficacy. The distribution pattern of cement has not been previously reported for patients with metastatic vertebral tumors. Material/Methods From January 2013 to December 2017, patients with metastatic vertebral tumors who met our criteria were divided into cement fusion (n=91) and separation (n=97) groups. Visual analogue scale (VAS) and middle vertebral height (MVH) were evaluated preoperatively, postoperatively, and 1 year after surgery. Spinal Instability Neoplastic Score, fluoroscopy time, operation time, cement volume, cement leakage, and vertebral fractures were recorded and evaluated. Results Compared with the fusion group, the separation group had significantly different (P<0.001) operation time, fluoroscopy time, and cement volume. Compared with preoperative status, VAS and MVH were significantly improved 3 days postoperatively and 1 year postoperatively in both groups (P<0.001). The difference in cement leakage between the 2 groups (P<0.05) and in the number of adjacent vertebral fractures between the 2 groups (P<0.05) were significant. Conclusions The distribution patterns of the bone cement had a good analgesic effect and preventive effect on vertebral collapse. However, the separation of bone cement may be safer.
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Affiliation(s)
- Zhangzhe Zhou
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Yimeng Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Zhiyong Sun
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Zhonglai Qian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
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Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture. ACTA ACUST UNITED AC 2019; 55:medicina55080426. [PMID: 31370309 PMCID: PMC6722751 DOI: 10.3390/medicina55080426] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/17/2019] [Accepted: 07/29/2019] [Indexed: 01/19/2023]
Abstract
Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients’ quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fractures and to compile their safety and efficacy results. Materials and Methods: A systematic MEDLINE/PubMed literature search was performed, time period included articles published between January 2000 and March 2019. Original articles were selected based on their clinical relevance. Results: Four studies of interest and other cited references were analyzed. These studies reported significant pain and function improvement as well as kyphotic angle and vertebral height restoration and maintain for every implant and technique investigated. Conclusions: Although good clinical performance is reported on these devices, the small numbers of studies and patients investigated draw the need for further larger evaluation before drawing a definitive treatment decision tree to guide physicians managing patients presenting with neoplastic vertebral compression fracture.
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[Metastatic breast cancer in the spine : Molecular predictors for choosing adequate treatment strategies]. DER ORTHOPADE 2019; 47:594-603. [PMID: 29487982 DOI: 10.1007/s00132-018-3540-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Breast cancer is the most common malignancy affecting women and the spinal column is most likely affected by metastases. Modern oncologic treatment options have significantly prolonged survival times in the last decade. Therefore, treatment of vertebral metastases has been of special interest in spine surgery. Different scores are described to evaluate prognosis and to choose correct treatment strategies, which however only differentiate tumor entities and not specific tumor phenotypes. Breast cancer has been classified into five intrinsic subtypes with different survival rates since the turn of the millennium. The aim of this review was to describe molecular predictors of breast cancer malignancy and to better estimate expected survival times and invasiveness of therapies with regard to spinal metastases.
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Mansoorinasab M, Abdolhoseinpour H. A review and update of vertebral fractures due to metastatic tumors of various sites to the spine: Percutaneous vertebroplasty. Interv Med Appl Sci 2018; 10:1-6. [PMID: 30363329 PMCID: PMC6167632 DOI: 10.1556/1646.10.2018.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Vertebral fractures (VFs) are the most usual convolution of metastatic tumors and the vertebral column is the third most ordinary site for painful bone metastases and remains a chief factor of morbidity in cancer patients. Methods In this paper, we investigated the previous literature on the status of clinical and prospects for the use of percutaneous vertebroplasty (PVP) with polymethylmethacrylate as a remedial alternative for the therapy of refractory pain resulting from malignant vertebral compression and pathologic fractures associated with metastatic tumors of various sites in numerous studies. The scientific document for this remedy, containing safety, immediate and long-term efficacy, and outcome measures, and also the risks of complications, was analyzed in detail. Results PVP is a safe, feasible, reliable, effective, and useful procedure, a minimally invasive treatment, and a significant tool for reduction of pain and the relief of pain symptoms. Conclusions This method can be employed as a further or narcotic remedy in elected patients. The techniques of PVP present a novel alternative therapy for diverse metastases with potentially large application.
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Affiliation(s)
| | - Hesam Abdolhoseinpour
- Department of Neurosurgery, Bou Ali Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
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