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PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine

Object: Patients with osteolytic metastases frequently suffer from serious local and radicular pain. Pathophysiologically, local pain arises from skeletal instability, whereas radicular pain originates from compression of nerve roots by local tumor growth. Causal treatment of osteolytic metastases i...

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Autores principales: Winking, Michael, Stahl, Jens-Peter, Oertel, Matthias, Schnettler, Reinhard, Böker, Dieter-Karsten
Formato: Texto
Lenguaje:English
Publicado: German Medical Science 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2703227/
https://www.ncbi.nlm.nih.gov/pubmed/19675706
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author Winking, Michael
Stahl, Jens-Peter
Oertel, Matthias
Schnettler, Reinhard
Böker, Dieter-Karsten
author_facet Winking, Michael
Stahl, Jens-Peter
Oertel, Matthias
Schnettler, Reinhard
Böker, Dieter-Karsten
author_sort Winking, Michael
collection PubMed
description Object: Patients with osteolytic metastases frequently suffer from serious local and radicular pain. Pathophysiologically, local pain arises from skeletal instability, whereas radicular pain originates from compression of nerve roots by local tumor growth. Causal treatment of osteolytic metastases in disseminated malignant disease is very difficult. Resection of vertebrae, in combination with ventro-dorsal stabilization, is a complex treatment for patients with a limited life expectancy. Percutaneous polymethylmethacrylate (PMMA) vertebroplasty is a new and easy method of relieving patients' pain. In addition, it is both cost effective and safe. Pain is reduced immediately after treatment. Due to the regained vertebral stability, early mobilization of the patients is possible. Methods: A total of 22 patients with osteolytic malignancies of the thoracic and lumbar spine were treated with PMMA vertebroplasty. Prior to and after surgery, then six weeks and six months after discharge from hospital, patients answered the Oswestry Low Back Pain Disability (OLBPD) Questionnaire for assessment of treatment-related change in disability. Percutaneous vertebroplasty was performed in a total of 19 patients. In three patients with tumor related compression of nerve roots an open neurolysis was performed followed by vertebroplasty. Results: A total of 86% of patients reported a significant pain reduction. Vertebroplasty was highly beneficial for patients with pain related to local instability of the spine, but less so in patients with additional nerve root compression. Extravasation of PMMA beyond the vertebral margins was observed in 23% of the cases. No treatment-related clinical or neurological complications were seen. Conclusions: PMMA vertebroplasty is a useful and safe method of pain relief for patients with malignant osteolytic diseases of the thoracic and lumbar spine.
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spelling pubmed-27032272009-07-28 PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine Winking, Michael Stahl, Jens-Peter Oertel, Matthias Schnettler, Reinhard Böker, Dieter-Karsten Ger Med Sci Article Object: Patients with osteolytic metastases frequently suffer from serious local and radicular pain. Pathophysiologically, local pain arises from skeletal instability, whereas radicular pain originates from compression of nerve roots by local tumor growth. Causal treatment of osteolytic metastases in disseminated malignant disease is very difficult. Resection of vertebrae, in combination with ventro-dorsal stabilization, is a complex treatment for patients with a limited life expectancy. Percutaneous polymethylmethacrylate (PMMA) vertebroplasty is a new and easy method of relieving patients' pain. In addition, it is both cost effective and safe. Pain is reduced immediately after treatment. Due to the regained vertebral stability, early mobilization of the patients is possible. Methods: A total of 22 patients with osteolytic malignancies of the thoracic and lumbar spine were treated with PMMA vertebroplasty. Prior to and after surgery, then six weeks and six months after discharge from hospital, patients answered the Oswestry Low Back Pain Disability (OLBPD) Questionnaire for assessment of treatment-related change in disability. Percutaneous vertebroplasty was performed in a total of 19 patients. In three patients with tumor related compression of nerve roots an open neurolysis was performed followed by vertebroplasty. Results: A total of 86% of patients reported a significant pain reduction. Vertebroplasty was highly beneficial for patients with pain related to local instability of the spine, but less so in patients with additional nerve root compression. Extravasation of PMMA beyond the vertebral margins was observed in 23% of the cases. No treatment-related clinical or neurological complications were seen. Conclusions: PMMA vertebroplasty is a useful and safe method of pain relief for patients with malignant osteolytic diseases of the thoracic and lumbar spine. German Medical Science 2003-11-20 /pmc/articles/PMC2703227/ /pubmed/19675706 Text en Copyright © 2003 Winking et al. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free to copy, distribute and transmit the work, provided the original author and source are credited.
spellingShingle Article
Winking, Michael
Stahl, Jens-Peter
Oertel, Matthias
Schnettler, Reinhard
Böker, Dieter-Karsten
PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title_full PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title_fullStr PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title_full_unstemmed PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title_short PMMA vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
title_sort pmma vertebroplasty in patients with malignant vertebral destruction of the thoracic and lumbar spine
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2703227/
https://www.ncbi.nlm.nih.gov/pubmed/19675706
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