Bone Tumor
Conditions
Keywords
PVP, bone tumor
Brief summary
Percutaneous vertebroplasty is a new technique to strengthen bone and reduce pain for patients with vertebral tumors
Detailed description
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.
Interventions
DRUGBone Cements
patents in PVP group will get injected with bone cement inside the collapsed malignant vertebra
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 100 Years
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain relief | immediate | 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 |
Countries
Egypt
Contacts
Primary Contactmustafa saed, MSc
Outcome results
None listed