Percutaneous Balloon Kyphoplasty Vertebral Augmentation for Compression Fracture Due to Vertebral Metastasis: A 12-Month Retrospective Clinical Study in 72 Patients

Abstract

BackgroundVertebral compression fracture is common in osteoporosis, but can also occur due to bone metastases, for which current treatment options are limited and include bone-strengthening with cement and supportive care. Kyphoplasty is a surgical method of bone augmentation that can reduce pain, stabilize vertebral bone, and restore some or all of the vertebral body height. The aim of this study was to investigate the clinical results of balloon kyphoplasty in the correction of vertebral deformity due to metastatic vertebral compression fracture.Material/MethodsA retrospective clinical study included 72 patients (82 vertebral bodies) with metastases resulting in vertebral compression fracture, treated by percutaneous balloon kyphoplasty; 9 patients were found incidentally to have vertebral metastases. Bone mineral density (BMD) levels were measured. Patient responses from questionnaires, including the visual analog scale (VAS) for pain intensity, and the Oswestry Disability Index (ODI) for disability, were scored. The local kyphosis angle (KA) and the vertebral height ratio (VHR) were measured. All patients were followed up for 12 months. The initial postoperative and 12-month postoperative values, and the preoperative and postoperative values were compared.ResultsFollowing balloon kyphoplasty, the KA, VHR, VAS, and ODI scores significantly improved at the final 12-month follow-up compared with preoperative levels (p<0.05, and p<0.001). There was cement leakage in 6 procedures (8.3%) and adjacent segment fracture in 11 procedures (15.2%).ConclusionsBalloon kyphoplasty was an effective method to reduce pain, reduce disability, and improve quality of life by eliminating kyphotic deformity in pathological vertebral compression fractures due to vertebral metastases.

Orta seviye torakal vertebra fraktürlerinde perkütan balon kifoplasti deneyimi

“…Although vertebral collapse fractures usually occur in the thoracolumbar region, mid-thoracic vertebra fractures can cause respiratory problems (8). The aim of the treatment of symptomatic vertebral collapse fractures is to correct the vertebral height, reduce the kyphosis angle and increase the quality of life (9). In mid-thoracic vertebral kyphoplasties, the small pedicle size of the vertebra, the risk of pneumothorax and segmental artery injury, and the presence of severe angulation caused by kyphosis not found in the lower thoracic and lumbar regions may pose special difficulties (10).…”

Technical Aspects, Safety, and Efficacy of Kyphoplasty in a Morbidly Obese Patient

“…Furthermore, opioid exposure for acute pain greater than 7 days could lead to long-term opioid use. In addition to pain relief, kyphoplasty provides correction of anatomy of the vertebral body, in terms of both height and angulation, while also improving mobility (16).…”

Should We Perform Routine Biopsy During Percutaneous Vertebroplasty in Vertebral Compression Fractures?

“…Differential diagnosis should include benign or Figure 1. T1-weighted, T2-weighted, and fat suppression sagittal magnetic resonance imaging show the involvement, compression, and edema of the vertebral body at L2/L5 levels malignant tumors, traumas, infections, tumor endocrinopathy, blood dyscrasias, and autoimmune diseases (4,11) . MM is a hematologic malignancy with lytic bone lesions.…”