title: Vertebral compression fracture treatment with vertebroplasty and kyphoplasty: experience in 407 patients with 1,156 fractures in a tertiary cancer center.
abstract: BACKGROUND
  Painful vertebral compression fractures (VCFs), whether pathologic or osteoporotic, are a source of morbidity in cancer patients. At our tertiary cancer center, over the past decade we have used vertebroplasty (VP) and kyphoplasty (KP) to treat painful VCFs. More data are needed on the treatment of VCFs in cancer patients with these techniques.
  
  
  METHODS
  We retrospectively reviewed the medical records of cancer patients with painful VCFs that had been treated at our institution between January 1, 2001 and May 31, 2008. Information was collected on demographic and clinical characteristics, features of the fractures, procedural details, and complications. Pre- and post-procedural pain and related symptoms were assessed using a subset of patients who had responded to the Brief Pain Inventory and the Edmonton Symptom Assessment Scale.
  
  
  RESULTS
  A total of 407 cancer patients had 1,156 fractures that had been treated with VP or KP during 536 surgical procedures. Patients had an average of 2.8 fractures (range, 1-10). The majority of patients had pathologic fractures due to multiple myeloma (43%) or osteoporotic fractures (35%). Most fractures occurred in the thoracolumbar region. Adjacent-level fractures occurred in 18% of patients. Surgery provided significant relief from pain and several related symptoms. Symptomatic, serious complications requiring open surgery occurred in two cases (<0.01%) in our series.
  
  
  CONCLUSIONS
  Our single-center experience revealed that a large number of cancer patients suffer from painful VCFs. The use of VP or KP in treating painful VCFs in cancer patients has good efficacy and an acceptably low complication rate.
authors: Houston Pain Associates, PLLC, Houston, TX 77030, USA. awburtonmd@gmail.com
authors: Allen W
authors: AW
authors: Burton
authors: Tito
authors: T
authors: Mendoza
authors: Rodolfo
authors: R
authors: Gebhardt
authors: Basem
authors: B
authors: Hamid
authors: Kent
authors: K
authors: Nouri
authors: Marco
authors: M
authors: Perez-Toro
authors: Joseph
authors: J
authors: Ting
authors: Dhanalakshmi
authors: D
authors: Koyyalagunta
mesh_terms: D002173:Cancer Care Facilities; D050815:Fractures, Compression / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000209:etiology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*