Evaluation of Incidentally Detected Pathology Results of Patients with Vertebral Fracture Treated by Vertebroplasty and Kyphoplasty: A Retrospective Study

Uzunoglu, Inan; Kaya, Ismail; Sucu, Hasan Kamil; Kızmazoğlu, Ceren; Sevin, Ismail Ertan; Aydın, Hasan Emre; Rezanko, Türkan; Yüceer, Nurullah

doi:10.1016/j.wneu.2018.10.116

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…Other investigations reported significantly higher incidence rates of unsuspected malignancy in biopsies during vertebroplasty and came to similar conclusions [ 9 ]. Hansen et al, Nowak et al, Li et al, and Uzunoglu et al observed an incidence of 4.9%, 3.1%, 2.9%, and 1.1% respectively [ 10 – 13 ]. Based on their results, Li et al further analyzed the economic burden due to routine biopsy.…”

Section: Resultsmentioning

confidence: 99%

“…Studies published within the last three years (after 2018) reported unexpected malignancies in only 1% of the cases [ 13 , 18 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Within the analyzed studies, most biopsies confirmed osteoporosis as the dominant underlying pathology of VCFs. This systematic analysis of the current literature demonstrates that transpedicular biopsies reveal an unexpected malignancy in about 0.4–6% [ 8 , 10 – 13 , 15 – 20 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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The role of routine transpedicular biopsies during kyphoplasty or vertebroplasty for vertebral compression fractures in the detection of malignant diseases: a systematic review

Osterhoff

Scheyerer

Spiegl

et al. 2022

Arch Orthop Trauma Surg

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Introduction Procedures like kyphoplasty or vertebroplasty have become an established treatment option for vertebral compression fractures (VCF). The transpedicular approach used during these procedures allows to take biopsies from the affected vertebral body. The aim of this study was to systematically summarize the existing knowledge on the value of routine transpedicular biopsies during kyphoplasty or vertebroplasty for vertebral compression fractures. Methods A systematic review of the literature using PubMed/Medline databases with the goal of finding all articles describing the value trans-pedicular biopsies for detecting primary bone tumors, metastases, bone diseases, or spondylitis in patients with vertebral compression fractures was performed. Search terms were (*biopsy/ OR biops*.ti,ab.) AND (vertebral compression fracture*.ti,ab.). Results Sixteen articles met the inclusion criteria, among these were six prospective and ten retrospective case series. Publication dates ranged from 2005 to 2020. A total of 3083 patients with 3667 transpedicular biopsies performed were included. Most biopsies confirmed osteoporosis as the dominant underlying pathology of VCFs. Transpedicular biopsies revealed an unexpected malignant diagnosis in 0.4–6% of the cases. Conclusion Routine transpedicular biopsies during kyphoplasty or vertebroplasty detect unexpected malignant lesions in 0.4–6% of the patients, even though the definition of “unexpected” varies among the analyzed studies. The evidence to support a routine biopsy is inconsistent. Nevertheless, routine biopsies can be considered, especially when sufficient preoperatvie imaging is not available or radiological findings are unclear.

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Section: Resultsmentioning

confidence: 99%

“…Studies published within the last three years (after 2018) reported unexpected malignancies in only 1% of the cases [ 13 , 18 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

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The role of routine transpedicular biopsies during kyphoplasty or vertebroplasty for vertebral compression fractures in the detection of malignant diseases: a systematic review

Osterhoff

Scheyerer

Spiegl

et al. 2022

Arch Orthop Trauma Surg

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“…In studies of conservative treatment options for VCFs, BKP has been shown to significantly reduce recovery time, pain, and mortality due to complications that result from prolonged bed rest in elderly patients (5,18). Moreover, malignancies can be detected incidentally in the biopsy results taken during the BKP procedure, providing earlier oncological diagnoses and treatment, prolonging survival (17).…”

Section: Discussionmentioning

confidence: 99%

“…Exclusion criteria were more than one operation, including additional spinal surgery (minimally invasive surgeries, decompression, stabilization, or injection) to any part of the spine before or at the same time as the TLJ operation, or during the follow-up period; fractures classified as A1-2, B, or C-type; patients with a preoperative malignancy diagnosis, or patients whose intraoperative biopsy results were compatible with malignancy or infection; and patients with diseases that impair bone metabolism (such as Paget or chronic renal failure), known or revealed by biopsy. The biopsies performed used routine BKP biopsy procedures (17).…”

Section: Patient Selectionmentioning

confidence: 99%

Is balloon kyphoplasty effective for bone remodeling of ao-type a3–4 fractures at the thoracolumbar junction

Uzunoglu¹,

Gürkan²,

Taskala³

et al. 2022

Turkish Neurosurgery

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AIM:To evaluate the parameters that affect bone retropulsion and restoration in patients with thoracolumbar junction (TLJ) vertebral compression fractures (VCF) without neurological deficits who underwent balloon kyphoplasty (BKP). MATERIAL and METHODS:Thirty-one of Frankel E and Arbeitsgemeinschaft für Osteosynthesefragen (AO) A3-4 type VCFs fractures at the TLJ, with bone retropulsion into the spinal canal, from 2017 to 2020, were evaluated retrospectively. Data was gathered on patient demographics and medical histories. Measurements of anterior vertebral heights, posterior vertebral heights, local kyphotic angles, spinal cord area, and bone retropulsion into the spinal canal (BRC) were evaluated preoperatively, early postoperatively, and late postoperatively. RESULTS:In those patients who underwent early surgery (<4 weeks postfracture), a significantly greater increase in anterior vertebral heights was seen between early postoperative and preoperative measurements than in patients who underwent late surgery (>4 weeks postfracture) (p=0.016). At the six-month follow-up, a significantly greater decrease in local kyphotic angle measurements was seen in patients over 65 years of age than those under 65 (p=0.023). Comparison of local kyphotic angles between sexes revealed a significant decrease in measurements at follow-up in female patients (p=0.029). Both early postoperative and late postoperative local kyphotic angle measurements of patients with a body mass index (BMI) ≥25 were significantly lower than those of patients with a BMI <25 (p=0.012). CONCLUSION:The restoration of vertebral angles and heights with the maximum level of BKP can effectively reduce BRC.

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Stellenwert der transpedikulären Biopsie bei Kypho- und Vertebroplastien von Wirbelkörperfrakturen

et al. 2022

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Zusammenfassung Hintergrund Transpedikuläre Zementaugmentationen sind eine etablierte Therapieoption in der Behandlung pathologischer Kompressionsfrakturen der Wirbelsäule. Neben der Osteoporose sind auch immer wieder metastasierte Grundleiden oder seltener ein primärer Knochentumor Ursache für Wirbelkompressionsfrakturen ohne adäquates Trauma. Ziel Erstellung eines aktuellen Meinungsbildes unter Wirbelsäulenchirurgen in Deutschland, der Schweiz und Österreich zum Stellenwert der transpedikulären Biopsie während Kypho- und Vertebroplastien von Wirbelkörperfrakturen. Material und Methoden Es wurde ein webbasierter UmfrageOnline®-Fragebogen mit 11 Fragen erstellt und an die E‑Mail-Verteiler der Deutschen Wirbelsäulengesellschaft (DWG), der Österreichischen Gesellschaft für Wirbelsäulenchirurgie (spine.at) und der Schweizerischen Gesellschaft für spinale Chirurgie (SGS) sowie an den E‑Mail-Verteiler der Sektion Wirbelsäule der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU) versendet. Ergebnisse Von insgesamt kontaktierten 2675 Wirbelsäulenchirurgen beantworteten 250 (9,3 %) die Umfrage. Rund ein Drittel (29,8 %) der Befragten führt regelhaft bei jeder Kypho- oder Vertebroplastie eine transpedikuläre Biopsie durch. Genannte Gründe für eine Biopsie waren ein bildmorphologischer (79,7 %) oder anamnestischer Verdacht auf eine Tumorerkrankung (66,0 %) oder das Vorliegen einer solchen (71,4 %). Als Gründe gegen eine routinemäßige Biopsie wurden die damit verbundenen Kosten und die limitierte Aussagekraft der gewonnenen Biopsate genannt. Diskussion Fast ein Drittel der befragten Wirbelsäulenchirurgen führt regelhaft bei jeder Kypho- oder Vertebroplastie eine transpedikuläre Biopsie durch. Fast alle Befragten führen Biopsien zumindest dann durch, wenn eine Tumorerkrankung bekannt ist bzw. aufgrund von Risikofaktoren vermutet wird. Zukünftige Studien müssen die Kosteneffizienz der transpedikulären Biopsie weiter abklären. Graphic abstract

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Evaluation of Incidentally Detected Pathology Results of Patients with Vertebral Fracture Treated by Vertebroplasty and Kyphoplasty: A Retrospective Study

Cited by 8 publications

References 24 publications

The role of routine transpedicular biopsies during kyphoplasty or vertebroplasty for vertebral compression fractures in the detection of malignant diseases: a systematic review

The role of routine transpedicular biopsies during kyphoplasty or vertebroplasty for vertebral compression fractures in the detection of malignant diseases: a systematic review

Is balloon kyphoplasty effective for bone remodeling of ao-type a3–4 fractures at the thoracolumbar junction

Stellenwert der transpedikulären Biopsie bei Kypho- und Vertebroplastien von Wirbelkörperfrakturen

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