Early clinical efficacy of bone filling mesh for vertebral metastases with posterior vertebral wall breakage

JIA Pu; CHEN Hao; BAO Li; FENG Fei; LI Jin-jun; TANG Hai

doi:10.3969/j.issn.2095-252X.2018.01.015

Abstract：Objective To evaluate the early clinical safety of bone filling mesh for vertebral metastases with posterior vertebral wall breakage. Methods From January 2014 to March 2017, 23 cases ( 27 segments ) suffering from vertebral metastases with posterior vertebral wall breakage were treated by bone filling mesh. There were 12 males and 11 females, with a mean age of ( 65.00 ± 11.23 ) years ( range: 40 - 90 years ). All patients had severe low back pain before the operation. Vertebral lesions were confirmed by preoperative imaging examination. The vertebrae with damaged posterior wall was treated by bone filling mesh under the C arm fluoroscopy. Other vertebral metastases were treated by PVP. Twenty-four cases received percutaneous unilateral pedicle puncture and mesh. Three cases received percutaneous bilateral pedicle puncture and double-mesh. VAS, ODI were evaluated before the operation and 72 hours after the operation respectively. X-ray and CT scan were conducted to observe bone cement leakage and complications. Results Twenty-three patients successfully completed the surgery. The average VAS decreased from ( 8.04 ± 0.69 ) to ( 2.92 ± 0.58 ) after the operation ( P < 0.05 ). ODI decreased from ( 83.33 ± 5.52 ) to ( 39.35 ± 7.16 ) after the operation ( P < 0.05 ). The intraspinal leakage rate of PMMA was 7.4％ ( 2 vertebrae ). No neurological symptoms or death appeared. Conclusions Bone filling mesh is simple and reliable for vertebral metastases with posterior vertebral wall breakage, which can significantly reduce pain, improve the quality of life and reduce the risk of bone cement leakage. The early clinical efficacy is satisfactory.