Vertebroplasty as a palliative treatment option for intractable pain in
pediatric patients with spinal tumors
Background: Primary and secondary malignant tumors of the spine are
relatively uncommon in the pediatric population but are associated with
high morbidity and significantly decreased quality of life due to pain.
Local management of these tumors is often challenging due to the
importance of maintaining vertebral mechanical integrity as well as the
spinal growth potential. Typically, surgery and/or radiation therapy
have been used in the primary management of these tumors. However,
treatment options become more limited when there is relapse or
refractory disease, with re-resection or additional radiotherapy often
not being viable therapies. The purpose of this study was to assess the
feasibility of percutaneous vertebroplasty as a palliative treatment for
intractable pain secondary to malignant tumors affecting the spine.
Procedure: A retrospective review of all cases of vertebroplasty
performed at a single institution between 2003 and 2020. Results: A
total of 11 vertebral levels were treated in 3 children with relapsed
cancers (two with alveolar rhabdomyosarcoma, and one with Wilms tumor).
All three had clinical benefit with sustained significant improvement in
their pain. Conclusions: Vertebroplasty is a currently underutilized
modality that might provide excellent pain palliation in cases of
relapsed cancer in the spine. Future prospective studies of its use in
pediatric oncology are needed.