gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Percutaneous kyphoplasty for palliation of thoracolumbar spine fractures due to malignancy – Procedure indications, limitations and results out of 5 years

Meeting Abstract

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  • corresponding author presenting/speaker Max Markmiller - Klinikum Kempten, Klinik für Unfall- und Wiederherstellungschirurgie, Deutschland

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO548

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Veröffentlicht: 20. März 2006

© 2006 Markmiller.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Question: Affection of the spine by cancer metastases threatens the oncologic patients with pain, loss of mobility and neurologic defects until up to paraplegia. Treatment options have to meet concerns of the short term prognosis, the limited operability and should allow quick mobilisation with a short hospital stay. An answer of the problem is the minimally–invasive percutaneous augmentation of the vertebral body by CT – guided dilatation and injection of bone cement (methylmethacrylate). The patients are able to stand up immediately after the procedure, surgical trauma and complication rates are minimized.

Methods: The patients were documented prospectively by ASA – Score and Karnovsky – Index. Percutaneous kyphoplasty was guided with CT and combined with fluoroscopy. All patients were aftertreated functionally with early mobilisation. Affection of the posterior vertebral wall or epidural involvement were no contraindications.

Results: From 01/2001 to 01/2006 out of 175 percutaneous vertebral augmentations 28 patients with metastatic lesions / malignant fractures were treated. In frequency the plasmocytoma leads with 32 %, followed by carcinomata of the prostate and the mamma with each 18 %, hypernephroma in 7 % and one patient each with carcinoma of the kidney, the thyroid gland, the liver, the cervix, the colon, the bronchus, one malignant melanoma and one lymphoma. The localisation favorites the thoracolumbar junction. The subjective evaluation of the treatment outcome using the Visual Analog Scale before and one week after the augmentation showed a decrease of the pain level of 60 % in 80% of the patients. All patients were mobile without any orthesis after the procedure. The clinical and radiological 6 – months followup confirmed the good results however 7 patients had died in between. Radiologically, all survivers showed an unaltered mechanical sufficient bone cement material. The complication rate is on the lower limit of the data published yet ( 6,8 % ). Clinically obvious complications refer to paravasations of the cement: over all patients three patients showed temporarily radiculopathy, three patients with paravasation in the intervertebral disc stayed asymptomatic. Three patients showed epidural paravasation, but no oncologic patient required surgical intervention. Summary: Percutaneous kyphoplasty is an excellent method of palliation for pain relief and mobility in oncologic patients with cancer metastases of the spine.