PURPOSE: To evaluate the benefits of minimally invasive balloon kyphoplasty (BKP) in patients with cancer and painful pathologic vertebral lesions. METHODS: In this longitudinal, prospective, consecutive study, patients received BKP at one or more vertebral levels. The BKP procedure was guided by computed tomographic fluoroscopy. Orthopaedic bone tamps were inflated to create a cavity and the fracture was stabilised using viscous polymethylmethacrylate bone cement. After the procedure, early mobilisation was encouraged. RESULTS: Overall, 115 patients (52.2% with vertebral fractures) received BKP. The majority (82.6%) of patients received BKP as a stand-alone procedure. BKP treatment provided significant (P<0.0001) improvements in Visual Analogue Scale (VAS)-pain (median change: -4), Oswestry Disability Index (ODI; mean change: -53.2), and Karnofsky Performance Status (KPS; median change: 15) scores at 6 and 12 months. In total, 23% of patients achieved increased vertebral height (7.4% mean improvement in angle index). The presence of height restoration and the number of levels treated did not affect VAS or ODI scores; improvements in KPS scores were numerically higher in patients who received BKP plus additional surgery (15-20) compared with stand-alone BKP (10-15). Mean hospital times were 7.2±6.5 days. The majority (97.4%) of patients showed no complications related to the procedure; three patients (2.6%) had a temporary radiculopathy. Incidences of cement leakage were observed in 40 patients (34.8%). CONCLUSIONS: Minimally invasive BKP provided excellent long-term palliation of pain and improved mobility in patients with cancer and painful osteolytic spinal lesions or vertebral fractures.
PURPOSE: To evaluate the benefits of minimally invasive balloon kyphoplasty (BKP) in patients with cancer and painful pathologic vertebral lesions. METHODS: In this longitudinal, prospective, consecutive study, patients received BKP at one or more vertebral levels. The BKP procedure was guided by computed tomographic fluoroscopy. Orthopaedic bone tamps were inflated to create a cavity and the fracture was stabilised using viscous polymethylmethacrylate bone cement. After the procedure, early mobilisation was encouraged. RESULTS: Overall, 115 patients (52.2% with vertebral fractures) received BKP. The majority (82.6%) of patients received BKP as a stand-alone procedure. BKP treatment provided significant (P<0.0001) improvements in Visual Analogue Scale (VAS)-pain (median change: -4), Oswestry Disability Index (ODI; mean change: -53.2), and Karnofsky Performance Status (KPS; median change: 15) scores at 6 and 12 months. In total, 23% of patients achieved increased vertebral height (7.4% mean improvement in angle index). The presence of height restoration and the number of levels treated did not affect VAS or ODI scores; improvements in KPS scores were numerically higher in patients who received BKP plus additional surgery (15-20) compared with stand-alone BKP (10-15). Mean hospital times were 7.2±6.5 days. The majority (97.4%) of patients showed no complications related to the procedure; three patients (2.6%) had a temporary radiculopathy. Incidences of cement leakage were observed in 40 patients (34.8%). CONCLUSIONS: Minimally invasive BKP provided excellent long-term palliation of pain and improved mobility in patients with cancer and painful osteolytic spinal lesions or vertebral fractures.
Authors: Matthias A König; Shah Jehan; Gopalakrishnan Balamurali; Michael Bierschneider; Andreas Grillhösl; Bronek M Boszczyk Journal: Eur Spine J Date: 2012-04-06 Impact factor: 3.134
Authors: L Joseph Melton; Robert A Kyle; Sara J Achenbach; Ann L Oberg; S Vincent Rajkumar Journal: J Bone Miner Res Date: 2004-11-29 Impact factor: 6.741
Authors: Daryl R Fourney; Donald F Schomer; Remi Nader; Jennifer Chlan-Fourney; Dima Suki; Kamran Ahrar; Laurence D Rhines; Ziya L Gokaslan Journal: J Neurosurg Date: 2003-01 Impact factor: 5.115