gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Cement salvage of instrumentation-associated vertebral fractures

Meeting Abstract

  • Ran Xu - Department of Neurosurgery, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Klinik für Neurochirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • George Krol - Department of Radiology, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  • Yoshiya Yamada - Department of Radiation Oncology, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  • Mark Bilsky - Department of Neurosurgery, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, USA
  • Ilya Laufer - Department of Neurosurgery, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, USA
  • Eric Lis - Department of Radiology, Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 062

doi: 10.3205/16dgnc437, urn:nbn:de:0183-16dgnc4376

Published: June 8, 2016

© 2016 Xu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Spinal instrumentation plays a key role in the treatment of spinal instability in patients with metastatic tumors. Poor bone quality, radiation, and diffuse osseous tumor involvement present significant challenges to spinal stabilization with instrumentation and occasionally result in postinstrumentation compression fractures. Vertebral cement augmentation has been effective in the treatment of painful tumor-related compression fractures. Our objective was to describe cement augmentation options in the treatment of vertebral compression fractures associated with spinal instrumentation in patients with metastatic tumors.

Method: Patients who underwent percutaneous vertebral cement augmentation in the treatment of instrumentation-associated vertebral compression fractures between 2005 and 2011 were included in the analysis. Only fractures that occurred within the construct or at an adjacent level were included. The change in Visual Analog Scale and need for further surgery were analyzed.

Results: Eleven patients met the inclusion criteria, with 8 tumors located in the thoracic spine and 3 tumors in the lumbar spine. The median time between instrumented surgery and vertebral augmentation was 5 months (1-48 months) and the median follow-up after cement augmentation was 24 months (4-59 months). A total of 22 vertebrae that were either within or immediately adjacent to the surgical instrumentation underwent vertebral augmentation. All patients reported a decrease in their pain scores (mean decrease: 6 Visual Analog Scale points; P < .003). One patient required reoperation after cement augmentation. None of the patients experienced vertebral cement augmentation-related complications.

Conclusions: Vertebral cement augmentation represents a safe and effective treatment option in patients with recurrent or progressive back pain and instrumentation-associated vertebral compression fractures.