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Is balloon kyphoplasty safe and effective for cancer‐related vertebral compression fractures with posterior vertebral body wall defects?
Author(s) -
Molloy Sean,
Sewell Mathew D.,
Platinum Johnson,
Patel Anand,
Selvadurai Susanne,
Hargunani Rikin,
Kyriakou Charalampia
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24222
Subject(s) - medicine , oswestry disability index , balloon , contraindication , vertebral body , surgery , percutaneous , low back pain , alternative medicine , pathology
Background and Objectives 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.