BACKGROUND: Operative and radiotherapeutic procedures are available for the treatment of symptomatic vertebral metastases. The method for treatment of vertebral metastases presented in this article involves a combination of intraoperative radiotherapy (IORT) and kyphoplasty. METHODS AND RESULTS: Kyphoplasty-IORT allows treatment of symptomatic vertebral metastases between vertebrae T3 and L5. With the patient under intubation narcosis an extrapedicular or bipedicular access to the vertebra is selected as for conventional kyphoplasty. This is followed by insertion of special sheaths of the radiation applicator and radiation therapy is intraoperatively administered via a radiation generator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Germany). The radiation dose is 8 Gy at a depth of 5-10 mm depending on the study protocol (50 kV X-radiation). Following radiation a conventional kyphoplasty procedure (Medtronic, USA) is carried out and the vertebra stabilized with cement. CONCLUSIONS: The procedure presented demonstrates a new approach to treatment of vertebral metastases and represents a valuable alternative to previously established methods.
BACKGROUND: Operative and radiotherapeutic procedures are available for the treatment of symptomatic vertebral metastases. The method for treatment of vertebral metastases presented in this article involves a combination of intraoperative radiotherapy (IORT) and kyphoplasty. METHODS AND RESULTS: Kyphoplasty-IORT allows treatment of symptomatic vertebral metastases between vertebrae T3 and L5. With the patient under intubation narcosis an extrapedicular or bipedicular access to the vertebra is selected as for conventional kyphoplasty. This is followed by insertion of special sheaths of the radiation applicator and radiation therapy is intraoperatively administered via a radiation generator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Germany). The radiation dose is 8 Gy at a depth of 5-10 mm depending on the study protocol (50 kV X-radiation). Following radiation a conventional kyphoplasty procedure (Medtronic, USA) is carried out and the vertebra stabilized with cement. CONCLUSIONS: The procedure presented demonstrates a new approach to treatment of vertebral metastases and represents a valuable alternative to previously established methods.
Authors: Jayant S Vaidya; David J Joseph; Jeffrey S Tobias; Max Bulsara; Frederik Wenz; Christobel Saunders; Michael Alvarado; Henrik L Flyger; Samuele Massarut; Wolfgang Eiermann; Mohammed Keshtgar; John Dewar; Uta Kraus-Tiefenbacher; Marc Sütterlin; Laura Esserman; Helle M R Holtveg; Mario Roncadin; Steffi Pigorsch; Marinos Metaxas; Mary Falzon; April Matthews; Tammy Corica; Norman R Williams; Michael Baum Journal: Lancet Date: 2010-07-10 Impact factor: 79.321
Authors: Frederik Wenz; Frank Schneider; Christian Neumaier; Uta Kraus-Tiefenbacher; Tina Reis; René Schmidt; Udo Obertacke Journal: Radiat Oncol Date: 2010-02-11 Impact factor: 3.481
Authors: Jeremy C Wang; Patrick Boland; Nandita Mitra; Yoshiya Yamada; Eric Lis; Michael Stubblefield; Mark H Bilsky Journal: J Neurosurg Spine Date: 2004-10
Authors: B Pinar Sedeño; N Rodríguez Ibarria; H Mhaidli Hamdani; T Fernández Varela; I San Miguel Arregui; D Macías Verde; P C Lara Jiménez Journal: Clin Transl Radiat Oncol Date: 2017-01-26