Efficacy analysis of co-ablation system combined with vertebroplasty for spinal metastases

English Keywords:Spinal metastases  Co-ablation system  Vertebroplasty  Total en bloc spondylectomy

English Abstract:

  【Abstract】 Objectives: To investigate the clinical efficacy of co-ablation combined with vertebroplasty for spinal metastases. Methods: 45 patients with spinal metastases admitted and treated in the Honghui Hospital, Xi′an Jiaotong University from September 2015 to September 2023 and met the inclusion criteria were analyzed retrospectively. 20 patients underwent co-ablation combined with vertebroplasty following decompressive laminectomy[Study group, 12 males and 8 females, 51.5±14.4(16-72) years; Thoracic spine 7 cases, lumbar spine 13 cases]; 25 patients underwent total en bloc spondylectomy[Control group, 14 males and 11 females, 53.7±13.8(26-72) years; Thoracic spine 11 cases, lumbar spine 14 cases]. There were no significant differences in the baseline data, such as age, gender ratio, affected segment, the site of primary tumor, the grades of epidural spinal cord compression(ESCC), spine instability neoplastic system(SINS) score, Tomita score and Frankel grades between the two groups(P>0.05). The operative time, intraoperative blood loss, and the time of receiving further chemoradiotherapy or targeted therapy were collected and analyzed. The visual analogue scale(VAS) score, European Organization for Research and Treatment of Cancer(EORTC) quality of life questionnaire bone metastases module(QLQ-BM22) score and Frankel grades were used to evaluate the degree of pain relief, the changes of quality of life, and the improvement of spinal nerve function before treatment and at 3d, 1 month and 6 months. The patients underwent enhanced CT or MRI examinations during follow-up period to observe local tumor progression. Results: All the patients in this study successfully underwent surgery. The operative time and intraoperative blood loss in study group(122.5±22.0min and 225.0±58.3mL) were significantly less than the value(217.6±7.4min and 1064.0±131.12mL) in control group(P<0.05). The VAS score and QLQ-BM22 score of the two groups at 3d, 1 month and 6 months after operation were significantly lower than those before operation, and the difference were statistically significant(P<0.05); The VAS score and QLQ-BM22 score of the study group at 3d and 1 month after operation were significantly lower than those in the control group(P<0.05); No statistically significant differences in VAS score and QLQ-BM22 score at 6 months after operation were found between the two groups(P>0.05); The study group received further chemoradiotherapy or targeted therapy for 5.10±1.17d after operation, while that in the control group was 10.84±1.82d, and the difference was statistically significant(P<0.05); The postoperative 6-month local tumor progression rate was 10%(2/20) in the study group and 12%(3/25) in the control group, with no statistically significant difference between the two groups(P＞0.05). Conclusions: The co-ablation system combined with vertebroplasty can successfully obtained a curative effect parallel to traditional total en bloc spondylectomy in short-term, while significantly reducing surgical trauma and minimizing any potential postoperative treatment interruptions or delays. This approach in treating patients with spinal metastases is both safe and effective.