R Pflugmacher1, P Beth, R-J Schroeder, K-D Schaser, I Melcher. 1. Centrum für Muskuloskeletale Chirurgie and Abteilung für Strahlenheilkunde, Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany. robert.pflugmacher@charite.de
Abstract
PURPOSE: To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by metastatic disease. MATERIAL AND METHODS: 64 balloon kyphoplasty procedures were performed in 31 patients (18 females and 13 males with bone metastasis), 28 of whom were followed up over a period of 1 year. Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). In the prospective 1-year follow-up, visual analog scale (VAS) and Oswestry Disability Score were documented. Radiographs were performed pre- and postoperatively, and at 3, 6, and 12 months. Vertebral height and kyphotic deformity were measured to assess restoration of the sagittal alignment. RESULTS: The median pain scores (VAS) decreased significantly (P<0.05) from pre- to post-treatment, as did the Oswestry Disability Score (P<0.05). Polymethyl methacrylate (PMMA) cement leakage was detected in eight of 64 vertebral bodies (12.5%), but did not have any clinical relevance. During 1-year follow-up, balloon kyphoplasty stabilized vertebral height and prevented further kyphotic deformity. CONCLUSION: Balloon kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by osteolytic lesions of vertebral bodies due to metastatic disease. It gives a statistically significant reduction of pain and prevents further kyphotic deformity of the spine.
PURPOSE: To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by metastatic disease. MATERIAL AND METHODS: 64 balloon kyphoplasty procedures were performed in 31 patients (18 females and 13 males with bone metastasis), 28 of whom were followed up over a period of 1 year. Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). In the prospective 1-year follow-up, visual analog scale (VAS) and Oswestry Disability Score were documented. Radiographs were performed pre- and postoperatively, and at 3, 6, and 12 months. Vertebral height and kyphotic deformity were measured to assess restoration of the sagittal alignment. RESULTS: The median pain scores (VAS) decreased significantly (P<0.05) from pre- to post-treatment, as did the Oswestry Disability Score (P<0.05). Polymethyl methacrylate (PMMA) cement leakage was detected in eight of 64 vertebral bodies (12.5%), but did not have any clinical relevance. During 1-year follow-up, balloon kyphoplasty stabilized vertebral height and prevented further kyphotic deformity. CONCLUSION:Balloon kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by osteolytic lesions of vertebral bodies due to metastatic disease. It gives a statistically significant reduction of pain and prevents further kyphotic deformity of the spine.