Percutaneous balloon kyphoplasty in the treatment of pathological vertebral body fracture and deformity in multiple myeloma: a one-year follow-up.
OBJECTIVE
To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by multiple myeloma.


METHODS
Vertebral fractures due to multiple myeloma were treated by balloon kyphoplasty (20 patients, 48 vertebral bodies). Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). During the following year, visual analog scale (VAS) and Oswestry disability score were documented. Radiographs were taken pre- and postoperatively 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 from pre- to posttreatment, as did the Oswestry disability score (p < 0.05). Clinically asymptomatic cement leakage occurred at 5 fracture levels (10.4%). During 1-year follow-up, this surgical technique demonstrated restoration and stabilization of the height of the vertebral body.


CONCLUSIONS
Balloon kyphoplasty is an effective minimally invasive procedure for stabilizing pathological vertebral fractures caused by multiple myeloma and leading to a statistically significant reduction of pain status. Balloon kyphoplasty stabilizes the vertebral body height, but is only partially able to prevent further kyphotic deformities.
Pflugmacher
R
R
Centrum für Muskuloskeletale Chirurgie, Abteilung für Radiologie, Universitätsmedizin Berlin, Charité Campus Virchow-Klinikum, Berlin, Germany. robert.pflugmacher@charite.de
Kandziora
F
F
Schroeder
R J
RJ
Melcher
I
I
Haas
N P
NP
Klostermann
C K
CK
D000368:Aged; D001827:Body Height / Q000502:physiology; D001843:Bone Cements / Q000627:therapeutic use*; D019299:Decompression, Surgical / Q000379:methods; D004185:Disability Evaluation; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009101:Multiple Myeloma / Q000150:complications*; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011859:Radiography; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate