Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma.
OBJECTIVE
We prospectively evaluated the safety and efficacy of kyphoplasty in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. The principle symptoms in multiple myeloma result from bone destruction, especially the spine. Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps (IBT) into the vertebral body. The purpose of the IBT is to restore the vertebral body back toward its original height, while creating a cavity that can be filled with highly viscous bone cement.


METHODS
Fifty-five consecutive kyphoplasty procedures were performed in 18 patients with osteolytic vertebral compression fractures resulting from multiple myeloma. Cement leakage and any complications were recorded. Early objective analysis was made by comparing preoperative and latest Short Form 36 Health Survey scores. Height restoration was estimated by measuring vertebral height on lateral radiographs.


RESULTS
The mean age of patients was 63.5 years, mean duration of symptoms was 11 months, and mean follow-up was 7.4 months. There were no major complications related directly to use of this technique. On average, 34% of height lost at the time of fracture was restored. Asymptomatic cement leakage occurred at two (4%) of 55 levels. Significant improvement in SF36 scores occurred for Bodily Pain (23.2 to 55.4, P =.0008), Physical Function (21.3 to 50.6, P =.0010), Vitality (31.3 to 47.5, P =.010), and Social Functioning (40.6 to 64.8, P =.014).


CONCLUSIONS
Kyphoplasty was efficacious in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. Kyphoplasty is associated with early clinical improvement of pain and function as well as some restoration of vertebral body height.
Dudeney
S
S
Department of Orthopaedics and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Lieberman
I H
IH
Reinhardt
M-K
MK
Hussein
M
M
D000368:Aged; D001843:Bone Cements; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007278:Injections, Spinal; D007738:Kyphosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D010014:Osteolysis / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D001843:Bone Cements