Comparison of percutaneous vertebroplasty with and without interventional tumor removal for spinal metastatic tumor without epidural involvement

Abstract Aim To evaluate the efficacy of percutaneous vertebroplasty (PVP) combined with interventional tumor removal (ITR) in providing pain relief, reducing disability, and improving functional performance in patients with malignant vertebral compression fractures without epidural involvement. Methods Patients with malignant vertebral compression fractures (n=58) were treated with either PVP+ITR (n=31, group A) or PVP alone (n=27, group B). A 14 G needle was inserted into the vertebral body, and the tract was sequentially dilated with working cannulae. When the last working cannula had reached the distal pedicle of vertebral arch, ITR was performed with a marrow nucleus rongeurs inserted through the working cannula. Finally, cement was injected into the excavated vertebral body. Patients were followed up at 1, 3, and 6 months after the procedure, and every 6 months thereafter. Results The overall excellent and good pain relief rate during follow-ups was significantly better in group A than in group B (94% vs.56%; p =0.002). The average VAS, ODI, and KPS scores at 3 months, 6 months, 1-year, and >1 year were all significantly lower in group A than in group B ( p