Percutaneous vertebroplasty with different viscosities of bone cement for treatment of thoracolumbar metastases

doi:10.3969/j.issn.2095-4344.1348

Abstract

Abstract:

BACKGROUND: Complications such as bone cement leakage are more common in percutaneous vertebroplasty. The choice of different filling materials has become an important factor affecting the surgical outcome.

OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with different viscosities of bone cement for treatment of thoracolumbar metastases.

METHODS: A total of 101 patients with bone metastases of malignant tumors, aged 52-87 years, who were admitted during June 2012 to October 2017 by Fifth Hospital in Wuhan, China were randomly assigned to undergo percutaneous vertebroplasty with Confidence high-viscosity bone cement (observation group, n=49, 103 vertebrae) or Heraeus low-viscosity bone cement (control group, n=52, 107 vertebrae). Within 48 hours after surgery, bone cement leakage was observed by imaging examination. The pain, clinical function and the height of the anterior border of the vertebral body as well as the kyphosis of the vertebral body were compared before surgery, 48 hours after surgery, and at the last follow-up. Adjacent vertebral fractures were statistically analyzed. This study was approved by the Ethics Committee of the Fifth Hospital in Wuhan.

RESULTS AND CONCLUSION: After surgery, the pain and clinical function of patients in the two groups were significantly improved compared with those before surgery (P < 0.05). There was no significant difference in pain and clinical function between the two groups at the same time point after surgery (P > 0.05). The height of the anterior border of the vertebral body and the degree of kyphosis of the vertebral body were significantly increased after surgery (P < 0.05). At different time points after surgery, the height of the anterior border of the vertebral body and the degree of kyphosis of the vertebral body were more obviously increased in the experimental group than in the control group (P < 0.05). Bone cement leakage rate in the observation group was significantly lower than that in the control group (16.50% vs. 22.43%, P < 0.05). There were no serious complications, such as recurrent fracture of adjacent vertebral bodies and pulmonary embolism, during the follow up period. These results suggest that high- and low-viscosity bone cement percutaneous vertebroplasty for treatment of thoracolumbar metastases can alleviate pain and improve quality of life with exact clinical efficacy and high safety. High-viscosity bone cement percutaneous vertebroplasty better recovers the height of the anterior border of the vertebral body, reduces the Cobb angles of kyphosis of the vertebral body, and lowers the risk of bone cement leakage than low-viscosity bone cement percutaneous vertesroplasty.

Key words: high-viscosity bone cement, low-viscosity bone cement, vertebroplasty, spine, metastases, pain, leakage, clinical function, height of the anterior border of the vertebral body, degree of kyphosis

CLC Number:

R459.9

Li Minghui, Liu Yang, Zhang Mi, Xu Feng . Percutaneous vertebroplasty with different viscosities of bone cement for treatment of thoracolumbar metastases [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(26): 4129-4135.

Figures/Tables 8

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