title: Kyphoplasty for the treatment of malignant vertebral compression fractures caused by metastases.
abstract: Despite the literature supporting the efficacy of kyphoplasty for treatment of osteoporotic vertebral compression fractures in multiple myeloma, few reports exist documenting its use in the treatment of malignant vertebral compression fractures (MVCF) caused by metastases. Accordingly, we sought to evaluate the feasibility, efficacy and safety of kyphoplasty in the treatment of MVCF without epidural involvement. We performed a retrospective review of clinical outcome data for 48 patients with multiple spinal metastases treated with kyphoplasty. Outcome data (vertebral body height variation, degree of kyphosis, visual analog scale score for pain, Oswestry Disability Index score, the Short Form-36 [SF-36] questionnaire score for function) were collected preoperatively, postoperatively, and at 1 month, 6 months, 1 year, and 2 years after treatment. Significant improvements in all of the outcome measures were observed postoperatively and throughout the duration of follow-up. The mean anterior vertebral body height variation improved from 52.7 ± 16.8% preoperatively to 85.3% ± 13.2% postoperatively (p < 0.001). Kyphotic angle improved from 16.4° ± 4.7° preoperatively to 8.4° ± 2.5° postoperatively (p < 0.001). The mean visual analog scale score decreased significantly from presurgery to postsurgery (7.4 ± 2.1 to 3.8 ± 1.6; p<0.001), as did the Oswestry Disability Index score (71.5 ± 16.7 to 32.4 ± 9.6; p<0.001). The SF-36 scores for bodily pain, physical function, vitality, and social functioning all also showed significant improvement (p<0.05). Kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by metastatic disease, even in levels with vertebral wall deficiency, leading to a statistically significant reduction in pain, improvement in function and prevention of further kyphotic deformity of the spine.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
authors.forename: Zhonglai
authors.initials: Z
authors.lastname: Qian
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Sun
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
authors.forename: Kangwu
authors.initials: K
authors.lastname: Chen
authors.forename: Guizhong
authors.initials: G
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000503:physiopathology*; D010147:Pain Measurement; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary; D013904:Thoracic Vertebrae / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome