Postavení perkutánní vertebroplastiky a kyfoplastiky v léčbě onkologického onemocnění páteře

Role of Percutaneous Vertebroplasty and Kyphoplasty in the Treatment of Oncology Disorders of the Spine

Background.
The aim of the study is to present results of a prospective uncontrolled clinical study. Percutaneous vertebroplasty or kyphoplasty are minimally invasive methods based on polymethylmethacrylate (PMMA) bone cement application into the damaged vertebra. This leads to decrease of the pain and vertebral body stabilisation. Oncology disorders of the spine are relatively common, having a wide alternative of various methods of treatment. Patients, according to their findings and indication criteria, are treated surgically or conservatively, oncological treatment is usually based on radiotherapy. Authors discuss the role of these invasive procedures in the treating algorithm of patients with spinal metasthases and multiple myeloma. 

Methods and Results.
From September 2003 to December 2005, 21 percutaneous vertebroplasties in 14 patients, mean age 68.7 (47–80) year, were performed in our department. During one treatment session 1–2 vertebrae (total of 21 vertebrae) in level Th9 – L5 were treated. Vertebroplasties and kyphoplasty were performed under fluoroscopy guidance. Transpedicular acces was used. Totally, 3 asymptomatic complications were proved. As first, a bone cement leaked paravertebrally during L5 body treatment, as second, a bone cement leaked into paravertebral veins, and as third, a bone cement leaked into the intervertebral space. Visual analog scale (VAS) was 8.9 points before procedure, 1.9 point 3 months after procedure and 2.6 points 6 months after procedure. We did not prove a symptomatic or total complication. 

Conclusions.
According to our experience, percutaneous vertebroplasty is an effective alternative treatment of painful oncologic spine disease. 

Key words:
percutaneous vertebroplasty, percutaneous kyphoplasty, spinal metastasis, management of spinal metastases, myeloma.