Role of Percutaneous Vertebroplasty in Treatment of Vertebral Tumors

Study Overview
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Brief Summary
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Percutaneous vertebroplasty is a new technique to strengthen bone and reduce pain for patients with vertebral tumors

Detailed Description
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Destructive vertebral lesions are a common in metastatic disease, multiple myeloma and lymphoma. Symptoms are caused by pathologic fracture consequences secondary to vertebral destruction, development of spinal instability and compression of adjacent neurological elements. Nonoperative treatments include radiotherapy, hormone therapy, cytotoxic drugs which are effective to halt the osteolytic process and reverse the neurological compromise, however; they cannot provide stability or relieve pain or cord compression. Surgical management options including vertebrectomy, reconstruction with a cage or PMMA bone cement, and stabilization with pedicle screws can restore spinal canal support and neurological functions also control pain, however; usually associated with high postoperative morbidity and mortality. Also not advisable for multifocal spinal disease. Percutaneous vertebroplasty is a new technique to strengthen bone and reduce pain. It is percutaneous, minimally invasive, image-guided procedure that involves injection of radio-opaque bone cement into a partially collapsed vertebral body, in an effort to provide stability and pain relief. The exact mechanism of pain relief remains unclear. Proposed theories include more favourable biomechanics after cement strengthening, chemical toxicity and exothermic effect of cement polymerization on nerve endings.

Official Title
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Role of Percutaneous Vertebroplasty in Treatment of Vertebral Tumors

Conditions
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Bone Tumor

Intervention / Treatment
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* Drug: Bone Cements


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Spinal instability Pain with movement Multiple level involvement Expected survival 3-6 months Exclusion Criteria: Absolute Asymptomatic improving on medical treatment without worsening of the collapse. infection local or systemic uncorrectable coagulopathy Allergy to bone cement or contrast media Relative Radicular pain Tumor extension inside the vertebral canal or cord compression Fracture of the posterior column Sclerotic metastasis Diffuse metastases

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| percutaneous Vertebroplasty<br>patients meet the inclusion and exclusion criteria will be subjected to percutaneous vertebroplasty receiving bone cement (Polymethyl methacrylate) | Drug: Bone Cements<br>* patents in PVP group will get injected with bone cement inside the collapsed malignant vertebra<br>* Other names: Polymethyl methacrylate;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain relief | reduction of spine pain following the injection of bone cement in the tumor according to Numeric Rating Scale, Improvement will be considered if NRS score decrease ≧ 20% after PVP | immediate | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PVP, bone tumor