Kyphoplasty for lytic tumour lesions of the spine: prospective follow-up of 11 cases from procedure to death

脊柱溶骨性肿瘤病变椎体成形术:11例患者从手术到死亡的前瞻性随访

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Abstract

BACKGROUND: The life span of cancer patients has improved due to advancements in cancer management. With long survival periods, more patients show metastatic disease. Osteolytic tumours of spine are generated by metastatic deposits or primary tumours of the spine. A prospective study was performed to evaluate the efficacy and safety of percutaneous kyphoplasty in patients with osteolytic tumours of the thoracic and lumbar spine. MATERIALS AND METHODS: Eleven patients (age range 52-77/average 65 years; 7 female, 4 male) with osteolytic tumours of the spine were treated with kyphoplasty. The main Tokuhashi score was registered preoperatively. Outcome was assessed prospectively by visual analogue scale (VAS) for pain, ECOG performance status, walking distance, standing and sitting time. RESULTS: Preoperative VAS (average 7.5; range 2.6-10) dropped to 3.0, 5 days postoperatively and remained below 5 for follow-up. Main Tokuhashi score was 6.3, ranging from 3 to 9. Survival time ranged from 2 to 293 (average 74.4) weeks. Average walking distance, standing and sitting time and ECOG performance score showed improvement. All patients returned home and no patient required re-operation or readmission due to local disease progression or recurrence. CONCLUSION: Kyphoplasty is a suitable palliative treatment option for patients with advanced metastatic disease of the spine even with low Tokuhashi scores allowing rapid pain relief and mobilisation to increase the quality of life.

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