Spine and Bone Tumor

IVR Treatment for Spine and Bone Tumors

When bone metastasis is suspected, it is not uncommon for the source of the cancer (primary site) to remain unidentified, a condition known as cancer of unknown primary. To help determine the appropriate treatment strategy, our clinic actively performs image-guided bone biopsy (tissue sampling).

For metastases to the spine and bones, we also perform IVR (interventional radiology) with the aims of relieving pain, stabilizing fractures, and achieving local control.

Main Bone IVR Treatments Performed at Our Clinic

Percutaneous vertebroplasty (PVP)

  • Medical bone cement is injected into a vertebra that has suffered a compression fracture to relieve pain and stabilize the bone.

Transcatheter arterial embolization (TAE) for tumors

  • By blocking the blood flow to the tumor, this treatment suppresses tumor growth and helps control pain and bleeding.

Radiofrequency ablation (RFA) for tumors

  • A needle is inserted into the tumor and the lesion is ablated with heat to relieve pain and suppress lesion growth.

An Example of IVR for Bone Metastasis

Metastatic lesion in the right hip bone (osteolytic change), with severe pain; the tumor is enhanced white by contrast medium
The feeding arteries are embolized via catheter (TAE)
CT-guided RFA was then performed
Reossification one year after treatment (pain also resolved)

By combining IVR treatments in this way, we control bone tumors and relieve pain.

Percutaneous vertebroplasty (PVP) is a treatment that can be expected to provide relatively rapid symptom relief for pain caused by compression fractures, and it is one of the IVR treatments we perform particularly actively at our clinic.

It is therefore described in more detail below.

What Is Percutaneous Vertebroplasty (PVP)?

Percutaneous vertebroplasty (PVP) is a treatment for compression fractures, in which a vertebra (vertebral body) is crushed by osteoporosis, metastatic bone tumors, or other causes. Bone cement is injected to relieve pain and stabilize the bone.

Pain from a compression fracture can make movement and walking difficult and have a major impact on daily life.

Our clinic also offers same-day treatment under local anesthesia, keeping the physical burden on the patient to a minimum.

In addition, using CT fluoroscopy to confirm the position in real time, we approach the fracture site accurately with careful attention to safety.

CT-guided bone puncture

Main Cases in Which PVP Is Considered

In general, PVP may be a treatment option in the following situations.

  • Ongoing pain due to a compression fracture of the thoracic or lumbar spine
  • No improvement with conservative treatment such as rest or a corset (brace)
  • Surgery is difficult due to advanced age, comorbidities, or other factors
  • The patient wishes to receive treatment with as little physical burden as possible

Eligibility is determined through a comprehensive evaluation of imaging findings, general condition, and other factors.

Features and Procedure of CT-Guided PVP

While confirming the position in real time with a CT scanner, a thin needle is advanced into the weakened part of the vertebra, and medical bone cement is injected to reinforce it.

Pain Relief

Relatively rapid pain relief can be expected in many patients.

Duration

The procedure takes about one hour from entering to leaving the treatment room.

Hospitalization / Outpatient Care

The procedure is performed on a same-day outpatient basis in principle, but an overnight hospital stay (two days, one night) is also available depending on your wishes and condition.

Before treatment (second lumbar vertebra)
The vertebral body has lost height, with low back pain
After treatment
White cement is seen inside the weakened vertebral body, and the pain has improved

Complications of PVP

Although we perform this treatment with careful attention to safety, the following complications have been reported.

Cement Leakage

If the injected cement leaks into the surrounding area, it may in rare cases cause neurological symptoms or embolism due to entry into blood vessels.

At our clinic, we perform the treatment while carefully monitoring with CT fluoroscopy.

Infection and Bleeding

Infection or bleeding may occur in association with the needle puncture.

Other

Very rarely, systemic complications such as allergic reactions or changes in circulatory dynamics may occur.

*In the unlikely event of a complication, we have a system in place that allows the attending physician and specialists in each field to respond promptly.

*Reference: Japanese Society of Interventional Radiology website, "What is vertebroplasty, in which bone cement is injected for spinal pain?"

Bone IVR Treatment at Our Clinic

As described above, in addition to PVP alone, our clinic combines treatments such as

to develop a treatment strategy suited to each patient's condition.

For pain associated with compression fractures and bone metastases, we draw on our skills as IVR specialists and on diagnostic imaging to provide treatment aimed at maintaining and improving quality of life (QOL).

If you have any questions, please feel free to consult us.