title: [Kyphoplasty in combination with intraoperative radiotherapy. Technical and regulatory characteristics of a concept for treatment of vertebral metastases].
abstract: BACKGROUND
  Operative and radiotherapeutic procedures are available for the treatment of symptomatic vertebral metastases. The method for treatment of vertebral metastases presented in this article involves a combination of intraoperative radiotherapy (IORT) and kyphoplasty.
  
  
  RESULTS
  Kyphoplasty-IORT allows treatment of symptomatic vertebral metastases between vertebrae T3 and L5. With the patient under intubation narcosis an extrapedicular or bipedicular access to the vertebra is selected as for conventional kyphoplasty. This is followed by insertion of special sheaths of the radiation applicator and radiation therapy is intraoperatively administered via a radiation generator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Germany). The radiation dose is 8 Gy at a depth of 5-10 mm depending on the study protocol (50 kV X-radiation). Following radiation a conventional kyphoplasty procedure (Medtronic, USA) is carried out and the vertebra stabilized with cement.
  
  
  CONCLUSIONS
  The procedure presented demonstrates a new approach to treatment of vertebral metastases and represents a valuable alternative to previously established methods.
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland. ralph.kayser@vivantes.de
authors.forename: R
authors.initials: R
authors.lastname: Kayser
authors.forename: S A
authors.initials: SA
authors.lastname: Ender
authors.forename: E
authors.initials: E
authors.lastname: Asse
authors.forename: E
authors.initials: E
authors.lastname: Wilhelm
authors.forename: F
authors.initials: F
authors.lastname: Adler
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
authors.forename: F
authors.initials: F
authors.lastname: Wenz
authors.forename: U
authors.initials: U
authors.lastname: Obertacke
authors.forename: F
authors.initials: F
authors.lastname: Bludau
mesh_terms: D000465:Algorithms; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D007796:Laminectomy / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D016896:Treatment Outcome