Purpose

To summarize the recommendations from the national clinical guideline published by the Danish Health Authority, regarding cemental augmentation as treatment for painful vertebral lesions, in patients with malignant disease.

Methods

A multidisciplinary working group formulated recommendations based on the GRADE approach.

Results

Two of the questions were based on randomized studies and one on professional consensus. The guideline recommends cemental augmentation for painful vertebral lesions in patients with malignant diagnosis, either hematological or non-hematological. Fracture of the posterior wall is not a contradiction to cemental augmentation, but care should always be taken while injecting the cement, to decrease the risk of cemental leaks into the spinal canal.

Conclusion

The recommendations are based on low-to-moderate quality of evidence or professional consensus as well as patient preferences and positive and harmful effects of the intervention. The working group recommends more randomized studies on patients with different malignant diseases and painful vertebral lesions comparing percutaneous vertebroplasty/kyphoplasty and conservative treatment to confirm the conclusion in this guideline.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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经皮椎体成形术治疗恶性椎骨病变：系统评价和GRADE评估得出丹麦国家临床指南。

目的

总结丹麦卫生局发布的国家临床指南中有关牙骨质增生作为治疗恶性疾病患者椎骨疼痛的建议。

方法

一个多学科工作组根据GRADE方法制定了建议。

结果

其中两个问题基于随机研究，一个基于专业共识。该指南建议对血液学或非血液学恶性诊断患者的椎体疼痛进行水泥骨增强治疗。后壁骨折与牙骨质增生并不矛盾，但在注射水泥时应始终小心，以减少牙骨质渗入椎管的风险。

结论

这些建议基于证据质量中低至中等或专业共识，以及患者的偏爱以及干预措施的积极和有害影响。工作组建议对不同恶性疾病和疼痛性椎体病变的患者进行更多随机研究，比较经皮椎体成形术/后凸成形术和保守治疗，以证实本指南的结论。

图形摘要

这些幻灯片可以在电子补充材料下找到。