Balloon kyphoplasty for the treatment of pathological fractures in the thoracic and lumbar spine caused by metastasis: 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 metastatic disease.


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.


CONCLUSIONS
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.
Pflugmacher
R
R
Centrum für Muskuloskeletale Chirurgie and Abteilung für Strahlenheilkunde, Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany. robert.pflugmacher@charite.de
Beth
P
P
Schroeder
R-J
RJ
Schaser
K-D
KD
Melcher
I
I
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011446:Prospective Studies; D020127:Recovery of Function; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate