Vesselplasty: A New Minimally Invasive Approach to Treat Pathological Vertebral Fractures in Selected Tumor Patients - Preliminary Results

Purpose: To evaluate the effectiveness and safety of percutaneous vesselplasty in pathological vertebral fractures of the thoracolumbar spine in selected tumor patients. Materials and Methods: Eleven pathological vertebral fractures in nine patients were treated with vesselplasty (Vessel-X (R), MAXXSPINE). Nine of eleven vertebras (81.8%) had major posterior wall deficiency (> 30 %). Clinical and radiological (CT) measures were obtained before and 3 months after the procedure. Results: The mean VAS improved significantly from preoperative to postoperative (6.9 +/- 2.2 to 3.7 +/- 2.3; p < 0.05), as did the ODI (59.7% +/- 19.2% to 40.3% +/- 24.0%; p < 0.05). The physical component summary of the SF-36 was significantly improved by the operation (19.2 +/- 8.0 to 31.0 +/- 16.5; p<0.05). Symptomatic cement leakage or other operation-associated complications were not observed. Three patients were primarily treated with concomitant minithally invasive stabilization via fixateur interne. One patient had to undergo minimally invasive stabilization via fixateur interne 4 months after vesselplasty due to further collapse of the treated vertebral body. Conclusion: From these preliminary results, vesselplasty appears to be a treatment option worth considering in pathological vertebral fractures, even in the case of posterior wall deficiency. Selected tumor patients might benefit from vesselplasty as a minimally invasive procedure for stabilization of the fractured vertebra, pain control, and improvement in body function and quality of life. Long-term prospective studies with a larger sample size are required to validate these results.