Balloon kyphoplasty for the treatment of pathological fractures in the thoracic and lumbar spine caused by metastasis: one-year follow-up

Acta Radiol. 2007 Feb;48(1):89-95. doi: 10.1080/02841850601026427.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Cements / therapeutic use
  • Decompression, Surgical / methods
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / surgery
  • Humans
  • Kyphosis / etiology
  • Kyphosis / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Orthopedic Procedures / methods
  • Pain Measurement / methods
  • Polymethyl Methacrylate / therapeutic use*
  • Prospective Studies
  • Recovery of Function
  • Spinal Fractures / etiology
  • Spinal Fractures / surgery*
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / secondary*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery*
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Bone Cements
  • Polymethyl Methacrylate