Supportive care aspects of vertebroplasty and kyphoplasty in patients with cancer.
As cancer survival rates continue to improve, many patients with cancer experience an increased incidence of osteolytic bone destruction that can lead to vertebral collapse. Many people with vertebral compression fractures develop pain and spinal deformity, mainly kyphosis. Kyphosis has been associated with a decrease in physical function, depression, loss of independence, decreased lung capacity, malnutrition because of early satiety, and death. Supportive care, focusing on alleviating pain and enhancing or preserving function for those with vertebral fractures, could be approached through nonoperative and operative treatments and will be reviewed in this article. Current nonoperative treatments of pathologic compression fractures include bed rest, bracing, physical therapy, bisphosphonates, and analgesics. Operative treatment currently includes minimally invasive cement augmentation techniques, such as vertebroplasty and kyphoplasty. These surgical options have shown promising short-term results for the treatment of painful metastatic and osteoporotic vertebral compression fractures. Vertebroplasty and kyphoplasty have the potential to decrease morbidity and mortality, which will allow patients with cancer the ability to improve parts of their life that were halted by pain and dysfunction.
Shindle
Michael K
MK
Department of Orthopaedic Surgery, Weill Medical College of Cornell University, Hospital for Special Surgery, New York.
Shindle
Lisa
L
Gardner
Michael J
MJ
Lane
Joseph M
JM