Turkish Neurosurgery 2016 , Vol 26 , Num 4
Long-Term Benefits of Percutaneous Anatomical Restoration of Vertebral Compression Fractures Linked to Malignancy
David Cesar NORIEGA1, Antonio KR▄GER2, Ruben Hernandez RAMAJO1, Francisco ARDURA1, MariFe MUNOZ3, Soner SAHIN4
1Valladolid University Hospital, Spine Unit, Department of Orthopedic, Valladolid, Spain
2Marburg University, Department of Trauma, Marburg, Germany
3Valladolid University Hospital, Department of Investigation, Valladolid, Spain
4Derince Research and Teaching Hospital, Department of Neurosurgery, Kocaeli, Turkey
DOI : 10.5137/1019-5149.JTN.12294-14.1 AIM: To evaluate the efficacy, feasibility and safety of a percutaneous anatomical vertebral body reduction for the treatment of VCF (vertebral compression fracture) linked to malignancy. Vertebroplasty and percutaneous kyphoplasty have played essential roles in the treatment of painful vertebral metastasis, although there are few reports with long survival that have evaluated the long-term efficacy, adjacent fractures and vertebral body (VB) re-collapse associated with these procedures. We aimed to evaluate the longterm efficacy and the complications associated with malignancy and changes in spinal biomechanics.

MATERIAL and METHODS: The retrospective study examined 32 patients with osteolytic VCF due to malignant infiltration of the vertebral body. A visual analogue scale, the EQ5 and radiological analysis (i.e., X-ray and CT scan) were used to assess back pain, quality of life and complications.

RESULTS: Statistically significant reductions in anterior and central vertebral body heights (6.2 mm-19.6 ▒ 4.2 mm- and 5.8 mm- 16.7 ▒ 7.8 mm-, respectively) that resulted in reductions of the regional Cobb angles exceeding 30% were observed. There was also a statistically significant improvement in quality of life. The average survival was longer than those reported in most published articles, and the average follow-up period was 30.9 months.

CONCLUSION: Anatomical restoration (i.e., cortical ring reduction with endplate rebalancing) is potentially beneficial for a wellselected group of patients with spine metastases and long life expectancies because this procedure avoids the complications typical of these types of treatments (e.g., leakage, adjacent fractures and re-collapse). Keywords : Percutaneous anatomical restoration, PMMA, Spine VCF, Malignant disease, Minimally invasive procedure

Corresponding author : David Cesar Norřega, noriega1970@icloud.com