title: Efficacy and safety of vertebral stenting for painful vertebral compression fractures in patients with metastatic disease.
abstract: OBJECTIVE
  Painful vertebral compression fractures in cancer patients reduce quality of life and may limit survival. We assessed pain relief, vertebral height restoration, and kyphosis correction following vertebral augmentation using a novel expandable titanium stent implant in cancer patients with painful vertebral compression fractures.
  
  
  METHODS
  Patients >18 years of age with metastatic disease who presented symptomatic compression fractures of vertebral bodies T5-L5, with or without a history of osteoporosis, were included in the study. Back pain at presentation, immediately after vertebral stenting, and at 1-, 3-, 6-, and 12-month follow-up was estimated using the visual analog scale (VAS). Vertebral height and local kyphotic angle (alpha angle) were measured on lateral standing X-ray before and 1-3 months after stenting.
  
  
  RESULTS
  Forty-one cancer patients with painful vertebral compression fractures underwent vertebral stenting procedures at 55 levels. There was no perioperative mortality and no significant complication. Median preoperative VAS was 8.0 (range 8-10), falling to 2.0 immediately postop (range 1-6, P  =  0.000) and 0 at all subsequent follow-up (P ≤ 0.012). Mean preoperative vertical height loss was 25.8% (range 0-84.0%) versus a postoperative mean of 18.0% (range 0-66.0%, P  =  0.000). Median pre- and postoperative kyphotic angle improved from 8.3° (range 0.2°-54.0°) to 7.1° (range 0.2°-25.0°, P  =  0.000). Wilcoxon signed rank test or student's t-test was used for comparisons.
  
  
  CONCLUSIONS
  Vertebral augmentation using a novel vertebral stenting system provided immediate and enduring pain relief and improved vertebral height loss and kyphotic angle.
authors.forename: Eyal
authors.initials: E
authors.lastname: Itshayek
authors.forename: Shifra
authors.initials: S
authors.lastname: Fraifeld
authors.forename: Andres A
authors.initials: AA
authors.lastname: Vargas
authors.forename: Josh
authors.initials: J
authors.lastname: Schroeder
authors.forename: Leon
authors.initials: L
authors.lastname: Kaplan
authors.forename: Yair
authors.initials: Y
authors.lastname: Barzilay
authors.forename: Guy
authors.initials: G
authors.lastname: Rosenthal
authors.forename: Yigal
authors.initials: Y
authors.lastname: Shoshan
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
mesh_terms: D001416:Back Pain / Q000209:etiology / Q000628:therapy*; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery; D006801:Humans; D058498:Kyphoplasty / Q000379:methods / Q000592:standards*; D008297:Male; D010147:Pain Measurement; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary; D015607:Stents; D014025:Titanium / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: Metastatic disease,; Pain,; Vertebral augmentation,; Vertebral compression fracture,; Vertebral stenting