Kai G.,Military Institute of Traumatic Orthopedics |
Chuan L.,Military Institute of Traumatic Orthopedics |
Fang L.,Military Institute of Traumatic Orthopedics
Chinese Journal of Tissue Engineering Research | Year: 2015
BACKGROUND: The development of minimally invasive technology significantly reduces the occurrence of surgical complications due to spinal metastases. Currently, the minimally invasive treatment basically has three broad categories: vertebral cement augmentation, radiofrequency ablation combined with vertebroplasty, intraoperative radiotherapy combined with vertebroplasty. OBJECTIVE: To summarize the research progress of three kinds of minimally invasive treatments for spinal metastases. METHODS: PubMed and Wanfang databases were searched using the keywords of “spinal metastases, vertebroplasty, radiofrequency ablation, radiotherapy” in English and Chinese, respectively. RESULTS AND CONCLUSION: Vertebral cement augmentation with good analgesic effect has been used widely, and the efficiency is up to 80%-90%. But its effect to kill tumors is very limited that is unable to control tumor growth. Radiofrequency ablation and radiation can kill the tumor, but cannot rebuild the vertebral stability. Therefore, the combination of different technologies can improve the therapeutic effect on spinal tumors. In recent years, intraoperative radiation and implantation of radioactive particles or radioactive bone cement have been developed as new technologies. However, there is no conclusion that these new technologies have better outcomes than the vertebral cement augmentation because of less reports and lack of long-term follow-up. Especially in the metastatic patients with damaged vertebral posterior wall and tumors invaded into vertebral canal, the risk of nerve function damage caused by bone cement leakage is still very high, even after many attempts. Above all, there is no a perfect minimally invasive treatment for spinal metastases. © 2015, Chinese Journal of Tissue Engineering Research. All rights reserved.