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.