INTRODUCTION
Malignant spine tumors are relatively rare in the pediatric population, with primary tumors such as Ewing sarcoma and osteosarcoma comprising less than 1% of all spine tumors 1. However, neoplasms such as lymphoma, neuroblastoma, and sarcoma can metastasize to the spinal axis and are not uncommon in clinical practice2,3. Although the development of new treatments may have improved overall survival, spinal tumors carry significant morbidity with risk of pathologic fracture and possible vertebral collapse with associated segment instability, spinal cord compression, and nerve root impingement 3. These structural changes often require prompt treatment and may require a multidisciplinary approach involving neurosurgeons, orthopedic surgeons, oncologists, radiation oncologists, pain specialists and interventional radiologists (IR). In a palliative context where pain control is fundamental to improve the overall quality of life, spinal tumors often present a significant challenge in children 4.
Minimally invasive spinal procedures performed by IR, such as tumor ablation and cementoplasty (vertebroplasty or kyphoplasty), are well accepted treatments for cancer-related pain or local disease control in adults with spinal tumors 5,6. These treatments can be used independently or in combination to provide pain relief and improve quality of life 6. However, the epidemiology, tumor histologic types and comorbidities of adults are completely different from oncologic pediatric patients. The value of these procedures in the pediatric population are still being investigated, with limited published literature available. The purpose of this study was to assess the feasibility of percutaneous vertebroplasty in children as a palliative treatment for intractable pain secondary to malignant tumors affecting the spine.