Abstract
Introduction
The spine is the most common site of bone metastases, with 33–70% of cancer patients acquiring spinal metastasis during the course of their disease. Vertebroplasty (VP) and Kyphoplasty (KP) have been proposed as potential minimally invasive therapeutic options for metastatic spinal lesion (MSL) pain. However, the efficacy of VP and KP on MSL pain is currently unclear. The Objective of the present review was to assess the effects of VP and KP on pain, disability and quality of life following MSL.
Material and Methods
We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) assessing VP or KP for the treatment of pain following MSL without cord compression. We searched MEDLINE, EMBASE and CENTRAL with no limitation in terms of study status (ongoing or completed), publication date, type or language.
Results
The literature search revealed 387 citations. Of these, nine trials met all eligibility criteria and included in the qualitative analysis. In total, there were 622 patients enrolled in the trials and of these 432 were in surgical treatment group (92 received KP, 97 received VP, 134 received VP and chemotherapy, 68 received VP and radiotherapy and 41 received KIVA implant) and 190 were in non-surgical treatment group (83 received chemotherapy, 46 received radiotherapy and 61 received other treatment). Using the grade approach, there is low quality of evidence that VP plus chemotherapy improve MSL pain and functional score more than chemotherapy alone (Pain: mean difference (MD): -3.01; 95%CI: -3.21 to -2.80; functional score: MD: 15.46; 95%CI: 13.58 to 17.34)
Conclusion
Pain and functional score improved more in VP plus chemotherapy group than in the chemotherapy group. Based on the analysis of published trial data, it is not known whether VP for MSL provides benefits over KP.