Percutaneous vertebral body consolidation is a less invasive method that both controls pain and increases the durability of the vertebral body. This method can also be applied in combination with radiotherapy and chemotherapy. However, the treatment of metastases with this method is technically more difficult and risky than the treatment of osteoporotic fractures. In most metastatic lesions, the tumor has invaded the epidural region and the posterior border of the vertebral body may not be intact. The risk of bone cement escaping into the epidural space is 10 times higher than for osteoportic fractures. Bone cement is easier to inject into the osteoportic vertebra than the vertebrae with tumors. Vertebral body resists injection due to tumor tissue. With the more advanced RF, Laser induced thermotherapy (LITT) or RF+plasma ablation methods, first the tumor tissue is burned, creating a cavity in the vertebra to reduce the resistance, and then the bone cement is injected. In this way, the complication rate is low and the chance of success is high.
In general, the treatment of osteoprotic fracture in patients with compression fracture is less risky and easy. In addition, the indications for this type of percutaneous intervention in patients with spinal metastases are very limited.
