Use of percutaneous kyphoplasty to treat painful vertebral compression fractures (VCF) in solid tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20568-e20568
Author(s):  
T. N. Elrafei ◽  
M. Hazza ◽  
N. Tindel
Keyword(s):  
Pain Score ◽  
Solid Tumors ◽  
Cord Compression ◽  
Vertebral Compression Fractures ◽  
Percutaneous Injection ◽  
Safety And Efficacy ◽  
Compression Fractures ◽  
Cancer Group ◽  
Visual Analog Pain Score ◽  
Benign Group

e20568 Background: Vertebral compression fractures are a major source of morbidity in metastatic carcinoma. Kyphoplasty involves inflation of a balloon for painful kyphotic deformity restoring the vertebral body to its original height and creating a cavity for percutaneous injection of polymethylmethacrylate (PMMA). Contraindications include epidural spinal cord compression. Although it is FDA approved for cancer-associated VCF most of the data is in the myeloma population. Methods: We retrospectively assessed by electronic medical records the safety and efficacy of kyphoplasties performed by the orthopedic spine service in a single institution between 12/03 and 2/08. We identified those patients who had kyphoplasty as the only spine procedure and excluded those patients with incomplete documentation of pain scores. Comparison was made between patients selected for pathologic compression fractures and benign compression fractures secondary to trauma or osteoporosis. Results: Review of 447 consecutive orthopedic spine cases identified 40 kyphoplasty patients, 30 of which met the inclusion criteria - 21 with benign compression fractures secondary to osteoporosis/trauma and 9 with malignant disease (3 breast CA, 2 lung, 1 cervix, 1 RCC, 2 myeloma). 49 kyphoplasties and 23 concurrent spine biopsies were performed in this group. Median age was in the cancer group was 55 (37–81) vs. 68(41–93) in benign group. One patient had prior radiation in the cancer group. The average preoperative visual analog pain score was 7 (range 3–9) and postoperative pain score was 2.0 (0–9) in the cancer group. The average preoperative visual analog pain score 6.8 (0–9) and post-operative score was 0.8 (0–4) in the benign group. Most procedures did not require general anesthesia. There were no reported PMMA extravasations, and no hematologic or neurologic complications in either group. Conclusions: Kyphoplasty provided marked pain relief in patients with VCF secondary to solid tumors and myeloma. The results are comparable to non-cancer population in safety and efficacy, and are feasible in selected cancer patients with pain due to pathologic compression fractures. [Table: see text]

Percutaneous vertebroplasty and/or kyphoplasty is an effective and safe treatment for painful vertebral compression fractures in multiple myeloma (MM)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7610-7610
Author(s):  
S. K. Thomas ◽  
M. L. Wang ◽  
K. Yao ◽  
H. Villareal ◽  
M. Fukshansky ◽  
...  
Keyword(s):  
Pain Score ◽  
Percutaneous Vertebroplasty ◽  
Controlled Delivery ◽  
Vertebral Compression Fractures ◽  
Vertebral Collapse ◽  
Percutaneous Injection ◽  
Compression Fractures ◽  
Refractory Pain ◽  
Epidural Compression ◽  
Visual Analog Pain Score

7610 Background: Painful vertebral compression fractures are a major source of morbidity in MM. Vertebroplasty involves percutaneous injection of polymethylmethacrylate (PMMA) into a vertebral body, while kyphoplasty involves inflation of a balloon for painful kyphotic deformity prior to stabilization with PMMA. Methods: We assessed safety and efficacy of 100 vertebroplasties and/or kyphoplasties in 81 consecutive myeloma patients between 12/2000 and 2/2005. Results: Median age was 63 (range 32–84), with 29% having prior radiotherapy to the vertebra treated. Contraindications included epidural compression of neural elements and failure to localize a symptomatic level. Kyphoplasty was preferred if kyphosis of > 20 degrees contributed to pain, or if the posterior vertebral cortex was disrupted so that controlled delivery of bone cement was difficult. Vertebroplasty was performed when vertebral collapse was either slight or so severe that insertion of balloon device was not possible, or if patient could not tolerate the general anesthesia required for kyphoplasty. The median preoperative visual analog pain score (0–10) was 8(range 2–10); the median postoperative pain score was 3 (range 0–10) (p < 0.01). There were no significant complications . Conclusions: Percutaneous vertebroplasty and kyphoplasty provided rapid and marked pain relief. These procedures are safe and feasible and represent the treatment of choice in selected MM patients with severe refractory pain due to pathologic compression fractures. No significant financial relationships to disclose.

Vertebroplasty and kyphoplasty: a comprehensive review

2005 ◽  
Vol 18 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Allen W. Burton ◽  
Laurence D. Rhines ◽  
Ehud Mendel
Keyword(s):  
Cord Compression ◽  
Vertebral Compression Fractures ◽  
Cardiovascular Collapse ◽  
Nerve Root Compression ◽  
Vertebral Metastasis ◽  
New Techniques ◽  
Technical Aspects ◽  
Benefit Ratio ◽  
Comprehensive Review ◽  
Compression Fractures

Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of bone cement, generally polymethyl methacrylate (PMMA), into a vertebral body (VB). Kyphoplasty is the placement of balloons (called “tamps”) into the VB, followed by an inflation/deflation sequence to create a cavity prior to the cement injection. These procedures are most often performed in a percutaneous fashion on an outpatient (or short stay) basis. The mechanism of action is unknown, but it is postulated that stabilization of the fracture leads to analgesia. The procedures are indicated for painful VCFs due to osteoporosis or malignancy, and for painful hemangiomas. These procedures may be efficacious in treating painful vertebral metastasis and traumatic VCFs. Much evidence favors the use of these procedures for pain associated with the aforementioned disorders. The risks associated with the procedures are low but serious complications can occur. These risks include spinal cord compression, nerve root compression, venous embolism, and pulmonary embolism including cardiovascular collapse. The risk/benefit ratio appears to be favorable in carefully selected patients. The technical aspects of the procedures are presented in detail along with guidelines for patient selection. A comprehensive review of the evidence for the procedures and the reported complications is presented.

scholarly journals Improved pain and quality of life outcomes after percutaneous vertebroplasty for thoraco-lumbar non-osteoprotic compression fractures

2019 ◽  
pp. 455-463
Author(s):  
Mostafa M. Nabeeh ◽  
Hanee A. Awad ◽  
Nabil M. Ali
Keyword(s):  
Quality Of Life ◽  
Percutaneous Vertebroplasty ◽  
Short Form ◽  
University Hospital ◽  
Invasive Technique ◽  
Vertebral Compression Fractures ◽  
Percutaneous Injection ◽  
Conservative Group ◽  
Compression Fractures

Introduction: Vertebroplasty is a minimally invasive technique in which percutaneous injection of bone cement under fluoroscopic guidance Percutaneous vertebroplasty (PVP) has been widely and successfully accepted in the treatment of osteoporotic and neoplastic vertebral compression fractures to control pain refractory to medical treatment. However, using of vertebroplasty as primary line treatment for traumatic, non-osteoporotic compression fractures still not widely accepted and considered a debatable issue. Patients and methods: This prospective comparative study was conducted at Neurosurgery department, Mansoura university hospital and Mansoura emergency hospital through the period between January 2015 and March 2016. 20 patients complaining of back pain due to single level thoracolumbar vertebral compression non-osteoprotic fractures were admitted to the study. Patients were divided into two groups 10 patients each, PVP group and conservative group. Outcome were assessed as regard pain improvement using Visual analogue scale VAS and quality of life using short form 36 scale (SF36). Results: Ten patients in the PVP group received Vertebroplasty, eight males (80%) and two females (20%) the age ranged from 29 to 62 years with mean age of 44.2+8.3 (mean+SD) years. The conservative group included ten patients seven males (70%) and three females (30%) the age ranged from 31 to 64 years with mean age of 45.1+9.2 (mean+SD) years. The level of injury ranged from D6 to L4. VAS and SF36 results showed significant improvement in post injection results compared to preinjection and to the conservative group Conclusion: Percutaneous vertebroplasty is safe and effective procedure to improve pain and quality of life in non osteoprotic patients complaining of traumatic compression fractures of thoraco-lumar region it decreases pain, and provide early ambulation of patients which improve their quality of life without significant morbidity.

Sign in / Sign up

Export Citation Format

Share Document