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Vertebroplasty as a palliative treatment option for intractable pain in pediatric patients with spinal tumors
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  • Leandro Cardarelli Leite,
  • Shahrad Rassekh,
  • Robert D'Ortenzio,
  • Manraj Heran
Leandro Cardarelli Leite
University of Western Ontario
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Shahrad Rassekh
British Columbia's Childen's Hospital
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Robert D'Ortenzio
The University of British Columbia
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Manraj Heran
University of British Columbia
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Abstract

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.

Peer review status:IN REVISION

22 Mar 2021Assigned to Editor
22 Mar 2021Submission Checks Completed
22 Mar 2021Submitted to Pediatric Blood & Cancer
23 Mar 2021Reviewer(s) Assigned
18 May 2021Review(s) Completed, Editorial Evaluation Pending
18 May 2021Editorial Decision: Revise Minor