Clinical and radiographic results of balloon kyphoplasty for treatment of vertebral body metastases and multiple myelomas

Dalbayrak, Sedat; Önen, Mehmet Reşid; Naderi, Sait

doi:10.1016/j.jocn.2009.04.007

Cited by 62 publications

(48 citation statements)

References 46 publications

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“…More commonly, follow-up imaging is performed with radiography or CT scanning, which are far less sensitive to soft-tissue visualization. 3,6,8,17,18 Also, in the absence of other reported cases, this phenomenon may be easily misinterpreted as general disease progression.…”

Section: Discussionmentioning

confidence: 97%

“…8 Since then, other nonrandomized series have replicated their reported rates of efficacy with similar low rates of serious complications. 6,17,18 Most recently, a randomized controlled trial confirmed both the efficacy and safety of BKP in the management of painful VCFs in cancer patients when compared with nonoperative therapies. 3 The BKP group had superior functional outcomes at 1 month, reductions in back pain, improvements in quality of life, and lower requirements of pain medications compared with the nonsurgical management group.…”

Section: Discussionmentioning

confidence: 97%

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Tumor extravasation following a cement augmentation procedure for vertebral compression fracture in metastatic spinal disease

Cruz

Sahgal

Whyne

et al. 2014

SPI

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Balloon kyphoplasty (BKP) has been proven to be safe and effective in the management of pathological vertebral compression fracture (VCF) due to metastatic spinal disease. The most common serious complications related to BKP include cement extravasation and new fractures at adjacent levels. Although the potential for “tumor extravasation” has been discussed as a potential iatrogenic complication, it has yet to be confirmed. The authors report on 2 cases of tumor extravasation following BKP, which they base on an observed unusual rapid tumor spread pattern into the adjacent tissues. They postulate that by increasing the vertebral body internal pressure and disrupting the tissues during balloon inflation and cement application, a soft-tissue tumor can be forced beyond the vertebral bony boundaries through pathological cortical defects. This phenomenon can manifest radiologically as subligamentous spread and/or extension into venous sinusoids, resulting in epidural venous plexus involvement, with subsequent tumor migration into the adjacent vertebral segments. Accordingly, the authors advise caution in using BKP when significant epidural tumor is present. The complication they encountered has caused them to modify their preference such that they now first use radiosurgery and subsequently BKP to ensure the target is appropriately treated, and they are currently developing possible modifications of procedural technique to reduce the risk.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Tumor extravasation following a cement augmentation procedure for vertebral compression fracture in metastatic spinal disease

Cruz

Sahgal

Whyne

et al. 2014

SPI

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“…Injection of polymethylmethacrylate (PMMA) into the sacrum increases osteoporotic bony resistance and also relieves pain through thermal and chemical factors (1,22,8). Sacroplasty was first reported in sacral metastatic lesions in 2001 (13).…”

Section: Introductionmentioning

confidence: 99%

Robotic assisted sacroplasty: a case report

Önen

Şi̇mşek²,

Naderi³

2013

Turkish Neurosurgery

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AIM: Sacral insufficiency fracture is an important cause of lower back and groin pain among the osteoporotic population. Diagnosis and treatment of SIFs are challenging. Currently, surgical treatment includes sacroplasty under C-arm fluoroscopy or computed tomography. Both techniques have a risk of accuracy and high radiation exposure. A sacral insufficiency fracture patient treated using robotic assisted surgery is presented and present literature is discussed. METHOD:A bilateral sacral insufficiency fracture patient with an additional L5 osteoporotic vertebra fracture is treated by bilateral percutaneous vertebroplasty using robotic assisted surgery. RESULTS:Robotic assisted surgery provided less x-ray exposure to the patient and the surgeon with additional accuracy and comfort. CONCLUSION:Robotic assisted surgery in treatment of sacral insufficiency fracture can be an important alternative method.

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“…Although radiotherapy is frequently used, pain relief may take weeks and restabilization months, if it occurs at all. In these patients less invasive techniques such as kyphoor vertebroplasty with immediate stabilization and faster pain relief, combined with short surgical times and low morbidity, have shown their effectiveness for stabilization, prevention of further deformity and pain reduction in several studies [9][10][11][12][13]. Furthermore, not only have surgical improvements occurred but there have also been improvements in radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Kyphoplasty and intra-operative radiotheray, combination of kyphoplasty and intra-operative radiation for spinal metastases: technical feasibility of a novel approach

Schmidt

Wenz

Reis

et al. 2012

International Orthopaedics (SICOT)

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Purpose To evaluate whether this new method is clinically applicable after theoretical and cadaver testing. Methods The incidence of spinal metastases requiring therapy is increasing, due to enhanced life expectancy. Due to results from studies with epidural compression a combined surgical and radiation therapy is often chosen. Minimal invasive cement augmentation is an increasingly used technique, due to fast pain relief and immediate stabilisation. On the other hand, stereotactic radiosurgery is considered to provide a more durable response and better local disease control than conventional radiotherapy with the application of higher doses. Therefore the combination of cement stabilisation and simultaneous intra-operative radiation with immediate stabilisation and high-dose radiation could be an interesting therapeutic option. The results of a clinical feasibility study are presented.Results 17 patients could be treated with the new method. In two patients (10%) intra-operative radiation could not be applied. No surgical interventions for complications were required. Conclusions Summarizing Kypho-IORT is technically feasible with an intra-operative risk profile comparable to sole kyphoplasty and a shorter treatment time and hospitalisation for the patients compared to conventional multifraction radiation. Radiation could not be applied in 10% of cases due to technical difficulties. The results of this feasibility study permit further evaluation of this new technique by a dose escalation study which is currently in preparation.

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Clinical and radiographic results of balloon kyphoplasty for treatment of vertebral body metastases and multiple myelomas

Cited by 62 publications

References 46 publications

Tumor extravasation following a cement augmentation procedure for vertebral compression fracture in metastatic spinal disease

Tumor extravasation following a cement augmentation procedure for vertebral compression fracture in metastatic spinal disease

Robotic assisted sacroplasty: a case report

Kyphoplasty and intra-operative radiotheray, combination of kyphoplasty and intra-operative radiation for spinal metastases: technical feasibility of a novel approach

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