title: Is balloon kyphoplasty safe and effective for cancer-related vertebral compression fractures with posterior vertebral body wall defects?
abstract: OBJECTIVE
  Balloon kyphoplasty (BKP) is a percutaneous treatment for cancer-related vertebral compression fractures (VCF). Posterior vertebral body wall (PVBW) involvement is considered a contraindication for BKP. This study assesses whether BKP is safe and effective for cancer-related VCFs involving the PVBW.
  
  
  METHODS
  This study analyzed data on 158 patients with 228 cancer-related VCFs who underwent BKP. One hundred and twelve patients had VCFs with PVBW defects, and 46 had VCFs with no PVBW defect. Outcomes were assessed preoperatively and at 3 months.
  
  
  RESULTS
  In the PVBW defect group, mean pain score decreased from 7.5 to 3.6 (P < 0.001), EQ5D increased from 0.39 to 0.48 and Oswestry Disability Index (ODI) decreased from 50 to 42. Cement leaks occurred in 31%. In the PVBW intact group, mean pain decreased from 7.3 to 3.3 (P < 0.001), EQ5D increased from 0.35 to 0.48 (P < 0.001), and ODI decreased from 53 to 50. Cement leaks occurred in 20%. No significant difference was observed in functional improvements between groups. Radiographically kyphotic angle and anterior and middle vertebral body heights were significantly worse in the PVBW defect group (P < 0.05).
  
  
  CONCLUSIONS
  BKP can alleviate pain and improve QoL and function in patients with cancer-related VCFs with PVBW defects with no appreciable increase in risk. J. Surg. Oncol. 2016;113:835-842. © 2016 Wiley Periodicals, Inc.
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Sean
authors.initials: S
authors.lastname: Molloy
authors.affiliation: Department of Spinal Surgery, The James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Sewell
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Johnson
authors.initials: J
authors.lastname: Platinum
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Anand
authors.initials: A
authors.lastname: Patel
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Susanne
authors.initials: S
authors.lastname: Selvadurai
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Rikin
authors.initials: R
authors.lastname: Hargunani
authors.affiliation: University College London Hospital, London, United Kingdom.|London North West Hospital, London, United Kingdom.
authors.forename: Charalampia
authors.initials: C
authors.lastname: Kyriakou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000295:instrumentation / Q000379:methods; D008223:Lymphoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000556:secondary; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: burst fracture; myeloma; osteoporosis; outcome; quality of life; tumor