The effect comparison of percutaneous vertebroplasty with kyphoplasty in the treatment of multi-segmental thoracic and lumbar spinal metastases

Objective: To compare the curative effects of radiofrequency ablation(RFA) combined with percutaneous vertebroplasty(PVP) and percutaneous kyphoplasty(PKP) in the treatment of multi-segmental thoracic and lumbar spinal metastases.Methods: One hundred and twelve patients with segmental metastases complicated with thoracolumbar vertebral compression fractures were randomly divided into the PVP group(58 cases,83 vertebras) and PKP group(54 cases,75 vertebras),the PVP and PKP group were treated with PVP and PKP,respectively.The pain degrees in two groups were evaulated using verbal rating scale before treatment and at 1 day after treatment.The vertebral height recovery,bone cement leakage,bleeding and hemopneumothorax in two groups were recorded after the surgery.The curative effects between two goups were compared after treatment.Results: The vertebral punctures in 112 patients were successful,all cases were followed up for 12 to 24 months.The difference of visual analoglle scales scores before surgery in two groups was not statistically signficant(P>0.05),the difference of visual analoglle scales scores of two groups between before surgery and at 1 day after surgery was statistically signficant(P<0.05).The heights of anterior vertebral body in PVP group and PKP group at 1 year after surgery rose to(79.85±4.21)% and(95.23±2.05)% of the normal average height,respectively,the difference of which was statistically signficant(P<0.05).The bone cement leakage in PVP group 22 cases(35 vertebras)and in PKP group 13 cases(16 vertebras).No bleeding case in two groups was found.Conclusions: The radiofrequency ablation combined with PVP and PKP for treating multi-segmental thoracic lumbar spinal metastases is good effects and less complications.The reduction effects of PKP are better than that of PVP,the PKP treatment is less leakage of bone cement.Treatment choice should be according to patients condition.