PERCUTANEOUS KYPHOPLASTY IN TUMORAL FRACTURES OF THE SPINE

Abstract

Introduction: Percutaneous kyphoplasty is a minimally invasive, radiologically guided procedure in which bone cement is injected into structurally weakened or destructed vertebrae. In addition to treating osteoporotic vertebral fractures, this technique gains popularity to relieve pain by stabilizing vertebrae compromised by, for example, metastases, aggressive hemangiomas or multiple myeloma that are at risk of pathologic fracture.

Materials and Methods: Retrospective study including 44 patients (67 fractures) who undergone percutaneous kyphoplasty from one or several tumoral fractures of the spine between January 2006 and February 2009. 77% were female. The mean age was 67. VAS scale and Karnofsky index were both measured pre and postoperatively. The most frequent lesion found was metastases from a primary tumor followed by myeloma.

Results: All patients were seated 24 hours after surgery. Partial or complete pain relief was obtained in 91% of patients (40/44); significant results were also obtained with regard to improvement in functional mobility and reduction of analgesic use. The mean value of the visual analogue scale (VAS) was 5.9 preoperatively, and significantly decreased to 3.3 one day after kyphoplasty. We reported 4 new vertebral fractures and no cases of cement extrusion during the follow-up. We didn’t report any case of neurological dysfunction after surgery.

Discussion: Most cases in our study show a significant improvement in pain and functionality with no associated complications. Kyphoplasty cement augmentation has been a safe and effective method in the treatment of symptomatic vertebral neoplasic compression fractures.