Author's Reply to the Letter to Editor, "Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension".

We appreciate and would like to thank Zhen Zhong Sun and Xuming Wei for their valuable and thoughtful comments after their thorough critical review of our paper “Sequential transarterial embolization followed by percutaneous vertebroplasty is safe and effective in pain management in vertebral metastases” (1). We would like to respond to the letter as follows. We agree with their suggestion that postoperative computed tomography (CT) should be performed to confirm whether there is shrinkage of the paravertebral lesion or tumor recurrence, which is helpful to find out the mechanism of pain change. We have already found the phenomenon of shrinkage of the paravertebral lesion or tumor after transarterial embolization and percutaneous vertebroplasty (PVP) procedures with CT, and we are collecting materials to form a paper. Zhenzhong Sun and Xuming Wei also argued: “The pain relief after PVP was not only related to the reinforcement of the vertebral body by bone cement, but also to the chemical and thermal effects, which may damage the sensory nerve endings and kill the tumor cells” (2). ”In addition, the space occupying effect of bone cement may inhibit tumor cell growth” (3). ”Therefore, to prevent local recurrence, we suggest Author's Reply to the Letter to Editor, “Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension”