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J Surg Oncol. 2016 Jun;113(7):835-42. doi: 10.1002/jso.24222. Epub 2016 Mar 21.

Is balloon kyphoplasty safe and effective for cancer-related vertebral compression fractures with posterior vertebral body wall defects?

Author information

1
The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
2
Department of Spinal Surgery, The James Cook University Hospital, Middlesbrough, United Kingdom.
3
University College London Hospital, London, United Kingdom.
4
London North West Hospital, London, United Kingdom.

Abstract

BACKGROUND AND OBJECTIVES:

Balloon kyphoplasty (BKP) is a percutaneous treatment for cancer-related vertebral compression fractures (VCF). Posterior vertebral body wall (PVBW) involvement is considered a contraindication for BKP. This study assesses whether BKP is safe and effective for cancer-related VCFs involving the PVBW.

METHODS:

This study analyzed data on 158 patients with 228 cancer-related VCFs who underwent BKP. One hundred and twelve patients had VCFs with PVBW defects, and 46 had VCFs with no PVBW defect. Outcomes were assessed preoperatively and at 3 months.

RESULTS:

In the PVBW defect group, mean pain score decreased from 7.5 to 3.6 (P < 0.001), EQ5D increased from 0.39 to 0.48 and Oswestry Disability Index (ODI) decreased from 50 to 42. Cement leaks occurred in 31%. In the PVBW intact group, mean pain decreased from 7.3 to 3.3 (P < 0.001), EQ5D increased from 0.35 to 0.48 (P < 0.001), and ODI decreased from 53 to 50. Cement leaks occurred in 20%. No significant difference was observed in functional improvements between groups. Radiographically kyphotic angle and anterior and middle vertebral body heights were significantly worse in the PVBW defect group (P < 0.05).

CONCLUSIONS:

BKP can alleviate pain and improve QoL and function in patients with cancer-related VCFs with PVBW defects with no appreciable increase in risk. J. Surg. Oncol. 2016;113:835-842. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

burst fracture; myeloma; osteoporosis; outcome; quality of life; tumor

PMID:
26996273
DOI:
10.1002/jso.24222
[Indexed for MEDLINE]

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