[Treating metastatic vertebral tumor with percutaneous vertebroplasty: a report of 28 cases].

BACKGROUND & OBJECTIVE: Treating metastatic vertebral tumor is a common difficulty. Conservative treatment can't efficiently release the pain, and establish the spinal column; while operation may destroy normal tissue, and cause many complications, which would prolong the time of in-hospital, and delay the treatment of primary disease, at the same time, operation is not suitable for multiple metastatic spinal tumors. This study was designed to investigate the efficacy of percutaneous vertebroplasty (PVP) on metastatic spinal tumor under the guidance of digital subtraction angiography (DSA). METHODS: A total of 58 patients with metastatic spinal tumor were divided into 2 groups according to their intention, 28 (group A) were treated with PVP combined radiochemotherapy, 30 (group B) were treated with routine radiochemotherapy. Baselines of the 2 groups have no significant difference. Two months after treatment, the life quality, therapeutic response, stabilization of the vertebral column, and toxic effect were compared between group A and group B. RESULTS: After treatment, both groups showed significant changes in life quality, and therapeutic response (P < 0.05, t(1)=2.74, t(2)=11.74). Group A showed no complication. Group B showed 5 cases of pathologic constrictive fracture in spinal body. CONCLUSION: PVP is a simple and minimally invasive treatment with few complications, which can release pain, decrease incidence of pathologic constrictive fracture in spinal body, and improve life quality of patients with metastatic spinal tumor.

[Repair of large bone defect due to excision of bone tumor with bone allograft].

OBJECTIVE: To study the reparative and reconstructive methods for the large bone defect due to the excision of bone tumor. METHODS: According to the size and shape of the bone defect, we selected the proper bone and joint or manipulated bone segment of the profound hypothermia freezing allograft and gave locked intramedullary nails or steel plate and screws for stable internal fixation. RESULTS: In the 22 cases, 20 survived without tumor and 2 died. One patient treated with the allograft of semi-knee joint was found rejection. Then the wound did not heal. After the skin flap grafting was performed, the wound still did not heal, so the patient accepted amputation(4.5%). In the other 21 cases, the X-ray and 99mTc SPECT showed some callus or concentration of nuclein which implied bone union. According to Markin bone graft criterion, the excellent rate of function recovery was 81.8%. CONCLUSION: Allografting of bone and joint is a good and workable method in repairing and reconstructing the bone defect due to the excision of bone tumor. It should be further studied and be applied.