Vertebroplasty for metastasis

Vertebral metastases are frequently asymptomatic; however, the occurrence of a pathological (micro-)fracture may be associated with unremitting pain, instability, and even kyphoscoliotic deformity and require prompt and effective treatment. In symptomatic patients, the beneficial effect of conservative therapies requires too much time. Vertebroplasty (VP) may be an additional or even alternative local treatment modality for such patients. Currently, up to 80% of VP patients report important relief of metastasis-related pain. Ongoing deformity of the vertebral body is avoided. Morbidity rates are very low and the complication rates are markedly below 10%. Fatalities, if any, are almost always the result of cancer comorbidity rather than related to the VP procedure itself. The patient's mobility is often improved, thus avoiding much of the comorbidity of prolonged conservative treatment and bed rest. VP can successfully be combined with chemotherapy, radiotherapy, neurodecompression, and instrumentation. Even though VP is no panacea, it may be helpful to selected patients and instantly improve quality of life. Currently, VP has a solid basis for the palliative treatment of thoracic, lumbar, and sacral metastasis.