1. What are the hazards of bone metastases from malignant tumors? Bone metastases are commonly found in the late stage of malignant tumors, and patients face long-term intractable pain, restricted activities and reduced quality of life, which may also lead to pathological fracture and spinal cord compression leading to paraplegia. For example, once spinal cord compression occurs in bone metastases, 90% of patients will suffer from low back pain, 50% of patients will not be able to walk, and 10-15% of patients will suffer from paraplegia. Moreover, malignant tumor bone metastasis can also lead to hypercalcemia, causing damage to the nervous system, kidney, gastrointestinal function, and in serious cases, it can lead to unresponsiveness and even coma. 2. Which tumors are prone to bone metastasis? Bone metastasis can be seen in any malignant tumors, but it is common in breast cancer, lung cancer, prostate cancer, thyroid cancer, cervical cancer, bone and soft tissue sarcoma and other malignant tumors. About 65%-75% of patients with advanced breast cancer and prostate cancer have bone metastasis, about 60% of patients with advanced thyroid cancer have bone metastasis, and about 30%-40% of patients with advanced lung cancer have bone metastasis. 3. What parts of malignant tumor are easily involved in bone metastasis? Bone metastases from malignant tumors are most likely to occur in the spine, pelvis, skull and limbs. Spinal bone metastases are the most common, among which 70% are in the thoracic spine, 20% in the lumbosacral spine and 10% in the cervical spine. 4.What tests should be performed if bone metastasis is suspected? There are many imaging methods to diagnose bone metastasis of malignant tumor, including X-ray, CT, MRI, radionuclide scan (ECT), PET-CT. X-ray is easy to perform and low cost, but it cannot detect early lesions; CT examination can accurately determine bone destruction; MRI examination can accurately respond to spinal cord and nerve compression. PET-CT can diagnose tumor metastasis in various parts of the body, which can reflect both the malignancy of the lesion and the location of the lesion, but the cost is higher. 5.What is percutaneous bone cement implantation? Percutaneous cement implantation is a minimally invasive treatment technique developed in the past 20 years. Under fluoroscopic or CT surveillance, a bone puncture needle is used to directly puncture through the skin, reach the vertebral lesion through the vertebral arch, and inject bone cement. 6.What clinical effects can percutaneous cement implantation achieve? ①Rapid pain relief, with an immediate pain relief rate of 75-94%. ②Kill tumor, the thermal effect and toxic effect of bone cement help to kill tumor cells. ③It can stabilize and strengthen the vertebral body, restore the strength and hardness of the vertebral body, prevent further collapse of the vertebral body, and even restore part of the height of the vertebral body. 7.What are the advantages of percutaneous bone cement implantation compared with other treatment modalities? Bone metastases can be treated surgically, but it is very traumatic and often not tolerated by elderly patients due to the combination of other organ diseases. Radiation therapy can relieve pain and control the progression of localized lesions, but does not improve spinal instability due to tumor destruction. However, percutaneous cement implantation has the advantages of minimally invasive, significant pain relief, small complications, and simultaneous tumor killing and spine stabilization. 8.Does percutaneous cement implantation require anesthesia? What are the precautions before and after surgery? Percutaneous bone cement implantation requires only local anesthesia and the patient remains awake. Patients can eat and drink normally before and after surgery, and they only need to lie down for 4-6 hours after surgery, and then they can get out of bed. 9. What tests should be performed before percutaneous bone cement implantation? In addition to the routine preoperative examination, MRI (magnetic resonance imaging) of the spinal cord should be performed to determine the involvement of the spinal cord, and CT examination of the corresponding vertebral body should be performed to understand the bone destruction of the vertebral body. 10.Do I need to be hospitalized for percutaneous bone cement implantation? Although percutaneous bone cement implantation is less invasive, it is necessary to complete the routine preoperative examination, observe the improvement of pain and evaluate the recovery of neurological function after the operation, and develop further treatment plans for the primary tumor. In contrast, outpatient treatment lacks monitoring facilities, and patients are recommended to be hospitalized for treatment. 11.Can elderly patients undergo percutaneous bone cement implantation? Percutaneous cement implantation is less invasive and the operation time is shorter, generally less than 1 hour for one vertebral body. Patients can undergo the procedure as long as they are able to lie prone for more than 1 hour. 12.Which patients cannot be treated by percutaneous cementation? Patients with infectious diseases such as vertebral tuberculosis and septicemia, patients with infection around the puncture site, patients with heart, lung, liver and kidney failure or coma. 13.Can multiple vertebral metastases be treated at one time? Yes. Depending on the patient’s physical condition and the time he can tolerate prone position, one to four vertebrae can be treated in one operation. 14.What other diseases can be treated by percutaneous bone cement implantation? Percutaneous cement implantation can also be used to treat: vertebral osteoporosis, vertebral compression fracture, vertebral hemangioma, and vertebral myeloma.