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Bone Pain in Cancer Patients: Mechanisms and Current Treatment.

The skeletal system is the third most common site for cancer metastases, surpassed only by the lungs and liver. Many tumors, especially those of the breast, prostate, lungs, and kidneys, have a strong predilection to metastasize to bone, which causes pain, hypercalcemia, pathological skeletal fractures, compression of the spinal cord or other nervous structures, decreased mobility, and increased mortality. Metastatic cancer-induced bone pain (CIBP) is a type of chronic pain with unique and complex pathophysiology characterized by nociceptive and neuropathic components. Its treatment should be

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… Vertebroplasty or kyphoplasty should be considered for patients who have vertebral metastases and show no evidence of mSCC or spinal instability, as well as patients who present with mechanical pain resistant to analgesia or the collapse of vertebral bodies [ 52 ]. … Minimally invasive procedures, such as balloon kyphoplasty or percutaneous vertebroplasty, may be beneficial in patients who have vertebral metastases without neurological compromise but with persistent pain. …

Cancer Pain Is Not One-Size-Fits-All: Evolving from Tradition to Precision.

Cancer pain remains a significant challenge in oncology, profoundly affecting patients' quality of life, function, and prognosis. Historically under-recognized and managed with a uniform, opioid-centric approach, cancer pain was often inadequately treated. Advances in pain assessment, multimodal analgesia, and supportive care have improved outcomes, yet traditional algorithms frequently fail to address the complex, heterogeneous nature of cancer pain. Contemporary management is shifting toward precision and personalized medicine, integrating genetic, molecular, and biomarker data with individu

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… In some cases, it is combined with cementoplasty (vertebroplasty/kyphoplasty) to provide structural stability. … Minimally Invasive Surgical Procedures: Vertebroplasty and kyphoplasty provide rapid pain relief and spinal stabilization in patients with painful vertebral metastases or compression fractures without neurologic compromise. …

Current Overview of Treatment for Metastatic Bone Disease.

The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of treatment for bone metastasis, it is important to exclude primary bone malignancy, which would require a completely different therapeutic approach. It is essential to select surgical methods considering the patient's prognosis, quality of life, postoperative function, and risk of pos

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… Less invasive spinal procedures include vertebroplasty, kyphoplasty, and minimally invasive spine stabilization with percutaneous pedicle screws. Vertebroplasty and kyphoplasty provide anterior column stability [ 104 ]. Vertebroplasty may relieve pain within 1-3 days [ 105 ]. … Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients J. Neurosurg. 2003 98 21 30 10.3171/spi.2003.98.1.0021 12546384 105. Itagaki M.W. Talenfeld A.D. Kwan S.W. Brunner J.W.M. Mortell K.E. Brunner M.C. …

Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients.

ObjectiveThe present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors.MethodsThis single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding cl

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… Due to the innovations of interventional radiology treatments in clinical practice, various methods for surgical intervention, including radiofrequency ablation (RFA), microwave ablation (MWA), iodine-125 seed brachytherapy, endoscopic techniques, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty … Abbreviations Bone cement Computed tomography 18 F-fluorodeoxyglucose Injectable artificial bone Magnetic resonance imaging Microwave ablation Positron emission tomography/computed tomography Percutaneous kyphoplasty Percutaneous vertebroplasty Radiofrequency ablation 36-item Short-Form Health …

The Missing Link: Integrating Interventional Pain Management in the Era of Multimodal Oncology.

Cancer-related pain (CrP) is one of the most frequent and debilitating issues that affect the quality of life of patients with cancer. Systemic analgesics, particularly opioids, have been the cornerstone of pain management. However, the following shortcomings of the mentioned therapies, such as side effects, tolerance, and inadequate relief in refractory cases, make implementing a more complete, multimodal treatment plan necessary. Interventional pain management (IPM) uses specific invasive procedures, with different degree of invasiveness, such as nerve blocks, neurolysis, neuromodulation, an

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… Kyphoplasty is similar to vertebroplasty, where a preliminary procedure (an operator percutaneously inserts, inflates, and deflates a balloon) is conducted before cement injection to facilitate the restoration of vertebral body height [ 125 ]. … Kyphoplasty in cancer: an encouraging step. Lancet Oncol. 2011;12(3):202–3. 126. Szylak R, Bhargava D, Pridgeon M, Srinivasaiah R, Vijayendra V, Osman-Farah J. Open thoracic cordotomy for cancer pain with intraoperative neuromonitoring: a case series and critical review of the literature. …

Diagnostic imaging for spinal disorders in the elderly: a narrative review.

The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population. While the prevalence of arthritis and degenerative

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… (Figure 2 ) MRI is also useful in determining whether fractures are acute or chronic and also prior to kyphoplasty procedures, for surgical planning, and to detect incidental pathology [ 82 ]. … Consider targeted CT scan with three-plane reconstruction to assess spinal stability and plan vertebroplasty, kyphoplasty or spinal surgery in patients with MSCC. Consider myelography if other imaging modalities are contraindicated or inadequate. …

Anaesthesia for fixation of repeated pathological fractures in a patient with multiple myeloma.

The introduction of new chemotherapeutic agents for the treatment of multiple myeloma (MM) has improved the life expectancy and quality of life for these patients in the last decade. Therefore, more patients with MM are being treated for repeated pathological fractures. The anaesthesiologist should continue the optimum supportive care received by these patients in the perioperative period also, by understanding the pathophysiology of the disease, the adverse effects of the chemotherapeutic agents and the guidelines for their supportive care. We report the perioperative management of a patient

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… Vertebral body collapse with spinal cord compression is an emergency in these patients requiring immediate vertebroplasty or kyphoplasty.[ 1 5 ] Renal failure commonly occurs because of damage to the renal tubules by the free light chains and hypercalcaemia due to osteolysis. …

Preoperative treatment and postoperative outcomes in osteoporotic patients with vertebral fractures: a longitudinal database study.

INTRODUCTION: This study aimed to investigate perioperative treatment and postoperative outcomes in osteoporotic patients with vertebral fractures (VFs), categorized by the type of spine surgery. MATERIALS AND METHODS: Patients aged ≥ 40, diagnosed with VFs and osteoporosis, with initial spine surgery between April 2015 and February 2021, were analyzed using a Japanese claims database. Time-to-event analysis was conducted for postoperative outcome. Outcome-related factors were explored with a multivariable Cox proportional hazards model. RESULTS: The study population (n = 4870) consisted of

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… Boonen S, Wahl DA, Nauroy L, Brandi ML, Bouxsein ML, Goldhahn J, Lewiecki EM, Lyritis GP, Marsh D, Obrant K, Silverman S, Siris E, Åkesson K, CSA Fracture Working Group of International Osteoporosis Foundation (2011) Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures … Ueno M, Tajima T, Ito S, Tsuji M, Toriumi E, Yoshii A, Otake N, Tanaka H (2024) Comparative analysis of anti-osteoporosis medications in preventing vertebral body fractures after balloon kyphoplasty. Arch Osteoporos 19:19. 10.1007/s11657-024-01374-7 36. …

Quality of life and supportive care in multiple myeloma.

UnlabelledMultiple myeloma is the second most common haematological malignancy. Novel therapies have led to improvement in survival. Current myeloma management is matching the progress made in improved survival through disease control while optimising quality of life with effective supportive care. Supportive treatment is an essential part of the therapeutic management of myeloma patients because it is directed towards improving the patient's quality of life and also can improve survival. The aim of this review is to highlight the relationship among life of quality, supportive care, and improv

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… Kyphoplasty involves the creation of a cavity in the vertebral body and filling it with highly viscous cement, which will result in complete or partial restoration of the collapsed vertebral body. Analgesics, bed rest, and bracing are the other interventions, whose benefits are limited. … The use of vertebroplasty or kyphoplasty may be considered in patients with persistent pain. …

Long-term follow-up of vertebral compression fractures in inpatients treated with integrative Korean medicine: An observational study.

Conservative management is the recommended first-line treatment for thoracolumbar vertebral compression fractures (VCFs), with integrative Korean medicine (IKM) being widely used for treatment in Korea. However, evidence regarding long-term treatment outcomes is lacking. We aimed to investigate the effectiveness of IKM treatment for thoracolumbar VCFs. Data from inpatients with thoracolumbar VCFs who received IKM treatment, comprising acupuncture, pharmacopuncture, electroacupuncture, Chuna manual therapy, and herbal medicine, at 4 KM hospitals from April 1, 2016 to June 30, 2022 were analyzed

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… Percutaneous vertebroplasty and percutaneous kyphoplasty are surgical treatments used in clinical practice to restore the vertebral body by injecting acrylic cement. … Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty. Spine J. 2012;12:998–1005. [31] Bang J, Kim G, Park SY, Jung HR, Kim S-H, Kim J-M. …

Advances in Imaging for Metastatic Epidural Spinal Cord Compression: A Comprehensive Review of Detection, Diagnosis, and Treatment Planning.

Metastatic epidural spinal cord compression (MESCC) is a critical oncologic emergency caused by the invasion of metastatic tumors into the spinal epidural space, leading to compression of the spinal cord. If not promptly diagnosed and treated, MESCC can result in irreversible neurological deficits, including paralysis, significantly impacting the patient's quality of life. Early detection and timely intervention are crucial to prevent permanent damage. Imaging modalities play a pivotal role in the diagnosis, assessment of disease extent, and treatment planning for MESCC. Magnetic resonance ima

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… Imaging guidance is also integral to minimally invasive procedures such as vertebroplasty and kyphoplasty, which stabilize vertebral fractures caused by metastatic lesions. … 50 The role of positron emission tomography and computed tomographic (PET/CT) imaging for radiation therapy planning: a literature review Diagnostics (Basel) Mallum A Mkhize T Akudugu JM Ngwa W Vorster M 53 13 2022 36611345 10.3390/diagnostics13010053 PMC9818506 51 Percutaneous vertebroplasty and kyphoplasty …

Vertebroplasty of cervical vertebra.

BACKGROUND: The first vertebroplasty was performed by Harve Deramond in France in 1984 due to a hemangioma of cervical vertebral body. Procedure technique consisted of inserting a needle through the bony palate of the oral cavity. Bone cement injected under pressure not only fills the areas of bone loss. The heat released in the process of crystallization causes denaturation of pathological tissue proteins (metastasis) and disrupts blood supply (hemangiomas). The aim of this study was to evaluate the method of treatment from anterolateral access. MATERIAL/METHODS: In the years 2007-2012 the p

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… Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine (Phila Pa 1976) 2006;31(23):2747–55. doi: 10.1097/01.brs.0000244639.71656.7d. …

Percutaneous vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: an evidence-based analysis.

UNLABELLED: OBJECTIVE OF ANALYSIS: The objective of this analysis is to examine the safety and effectiveness of percutaneous vertebroplasty … o compared vertebroplasty with conservative treatment, and one compared vertebroplasty with balloon kyphoplasty. RANDOMIZED CONTROLLED TRIALS: Recently, the results of two blinded randomized placebo-controlled trials of percutaneous vertebroplasty were reported. These trials, providing the highest quality of evidence available to date, do not support the use …

Множественная миелома с участием позвоночника: Ренальская дисфункция и альбуминуриа ассоциируются с прогрессивной саркопией в продольном морфометрическом исследовании КТ.

Почечная дисфункция является частым осложнением множественной миэломы (ММ). Однако ее связи с саркопией и вязкой адиозной потерей тканей, возникающими прогнозными маркерами слабости, по-прежнему недостаточно характеризуются в MM. Расчетная морфометрия на основе томографии (КТ) обеспечивает объективную и воспроизводимую оценку состава тела. Альбуминуриа, установившийся маркер повреждений почек, часто недооценивается за пределами нефрологии, несмотря на то, что она может иметь отношение к бремени болезней и физическому спаду. МЕТОДЫ: Мы ретроспективно проанализировали 86 Пациенты MM2009-2024) с

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… Similarly, the prevalence of pathological vertebral fractures, multiple vertebral fractures, kyphoplasty rates, and neurological deterioration according to the ASIA classification did not significantly differ between groups. … While baseline sarcopenia was not associated with greater fracture burden, kyphoplasty rates, or neurological deterioration, sarcopenic patients demonstrated significantly worse functional outcomes during follow-up, including poorer ECOG performance status, increased pain intensity, higher analgesic …

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Surgical Intensity and Survival After Surgery for Extradural Spinal Metastases: Mechanical Instability, Tumor Biology, and Systemic Reserve.

Background/Objectives: Surgery for extradural spinal metastases must balance neurologic and mechanical goals against limited survival. We evaluated whether a predefined three-tier surgical-intensity classification aligned with established measures of operative burden and whether intensity was associated with 90-day mortality or overall survival. Methods: This retrospective cohort included 141 adults with extradural spinal metastases operated on between June 2020 and December 2025. Surgical intensity was classified as low, moderate, or high. SMII was calculated for all patients as a secondary c

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… Stand-alone percutaneous vertebroplasty or kyphoplasty performed without decompression or tumor surgery was also excluded. No additional patients from the 150-patient source cohort were excluded beyond the nine intradural metastasis cases. 2.3. … Cement augmentation denoted cement use as an adjunct to decompression or tumor surgery, including cement-augmented fixation or vertebroplasty/kyphoplasty performed additionally to decompression; stand-alone augmentation-only procedures were excluded. …

The role of vitamin D and vitamin D deficiency in orthopaedics and traumatology-a narrative overview of the literature.

Vitamin D is considered to play an important role in musculoskeletal health. It's classical function is the regulation of calcium and phosphate homeostasis, thus ensuring a balanced bone metabolism that is characterised by an equal amount of bone resorption and bone formation. In the past decades, a plethora of pre-clinical and clinical studies reporting on potential health-beneficial properties of vitamin D have emerged. Moreover, there is an abundance of reports highlighting vitamin D deficiency and insufficiency in patients with almost innumerable diseases. Further, it is estimated that mor

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… A recent study showed a possible role of vitamin D status in the occurrence of postkyphoplasty recurrent vertebral compression fractures in elderly patients undergoing kyphoplasty due to osteoporotic fractures ( 53 ). … Hypovitaminosis D as a risk factor of subsequent vertebral fractures after kyphoplasty. Spine J 2012;12:304-12. 10.1016/j.spinee.2012.02.016 54. Maier GS, Seeger JB, Horas K, et al. The prevalence of vitamin D deficiency in patients with vertebral fragility fractures. …

European guidance for the diagnosis and management of osteoporosis in postmenopausal women.

Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis.IntroductionThe International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting.MethodsSystematic reviews were updated.ResultsThe following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture

Clinical Oversight and Delayed Diagnosis of a Pathological Compression Fracture Causing Paraplegia.

While osteoporosis is the primary cause of vertebral compression fractures (VCFs), it's crucial to promptly recognize pathological fractures through comprehensive diagnostic tests, including vertebral biopsies, to determine the exact etiology. For instance, a 66-year-old male with osteoporosis experienced worsening lower limb weakness and back pain after an initial vertebroplasty for a T12 compression fracture. Subsequent MRI revealed severe circumferential extradural compression at T12, leading to further surgeries that eventually uncovered metastatic adenocarcinoma from a pancreatic tumor. T

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… Surgical options include decompression with stabilization, en bloc resection, percutaneous kyphoplasty/vertebroplasty, or minimally invasive corpectomy [ 19 ]. …

Vertebroplasty in the treatment of recalcitrant lower back pain attributed to Modic 1 changes.

Vertebroplasty is a recognised treatment for osteoporotic and pathological compression fractures. We present the case of TF, a 70-year-old male patient with a history of poor left ventricular function presenting with refractory lower back pain, thought to be secondary to Modic Type1 changes in the L2 and L3 vertebrae, accompanying L2-L3 degenerative disc disease. He was treated conservatively for approximately 9 months without success. Following recent suggestions that vertebroplasty may provide pain relief in patients with degenerative disc change and coexistent Modic 1 changes not responding

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… Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ont Health Technol Assess Ser 2016; 16: 1–202. 23. Buchbinder R, Golmohammadi K, Johnston RV, Owen RJ, Homik J, Jones A. …