Percutaneous balloon kyphoplasty of malignant lesions of the spine: a prospective consecutive study in 115 patients.

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.