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  • Title: Percutaneous balloon kyphoplasty of malignant lesions of the spine: a prospective consecutive study in 115 patients.
    Author: Markmiller M.
    Journal: Eur Spine J; 2015 Oct; 24(10):2165-72. PubMed ID: 25566968.
    Abstract:
    PURPOSE: To evaluate the benefits of minimally invasive balloon kyphoplasty (BKP) in patients with cancer and painful pathologic vertebral lesions. METHODS: In this longitudinal, prospective, consecutive study, patients received BKP at one or more vertebral levels. The BKP procedure was guided by computed tomographic fluoroscopy. Orthopaedic bone tamps were inflated to create a cavity and the fracture was stabilised using viscous polymethylmethacrylate bone cement. After the procedure, early mobilisation was encouraged. RESULTS: Overall, 115 patients (52.2% with vertebral fractures) received BKP. The majority (82.6%) of patients received BKP as a stand-alone procedure. BKP treatment provided significant (P<0.0001) improvements in Visual Analogue Scale (VAS)-pain (median change: -4), Oswestry Disability Index (ODI; mean change: -53.2), and Karnofsky Performance Status (KPS; median change: 15) scores at 6 and 12 months. In total, 23% of patients achieved increased vertebral height (7.4% mean improvement in angle index). The presence of height restoration and the number of levels treated did not affect VAS or ODI scores; improvements in KPS scores were numerically higher in patients who received BKP plus additional surgery (15-20) compared with stand-alone BKP (10-15). Mean hospital times were 7.2±6.5 days. The majority (97.4%) of patients showed no complications related to the procedure; three patients (2.6%) had a temporary radiculopathy. Incidences of cement leakage were observed in 40 patients (34.8%). CONCLUSIONS: Minimally invasive BKP provided excellent long-term palliation of pain and improved mobility in patients with cancer and painful osteolytic spinal lesions or vertebral fractures.
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