This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dudeney, S. Articles by Hussein, M. Search for Related Content PubMed PubMed Citation Articles by Dudeney, S. Articles by Hussein, M. Social Bookmarking                            What's this?

Kyphoplasty in the Treatment of Osteolytic Vertebral Compression Fractures as a Result of Multiple Myeloma

From the Department of Orthopaedics and Minimally Invasive Surgery Center, Cleveland Clinic Foundation; and the Multiple Myeloma Program, the Cleveland Clinic Tausig Cancer Center, Cleveland, OH.

Address reprint requests to I.H. Lieberman, MD, Department of Orthopaedics, Minimally Invasive Surgery Center, 9500 Euclid Ave Desk A-41, Cleveland, Ohio, 44195; email: lieberi{at}ccf.org

PURPOSE: We prospectively evaluated the safety and efficacy of kyphoplasty in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. The principle symptoms in multiple myeloma result from bone destruction, especially the spine. Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps (IBT) into the vertebral body. The purpose of the IBT is to restore the vertebral body back toward its original height, while creating a cavity that can be filled with highly viscous bone cement.

PATIENTS AND METHODS: Fifty-five consecutive kyphoplasty procedures were performed in 18 patients with osteolytic vertebral compression fractures resulting from multiple myeloma. Cement leakage and any complications were recorded. Early objective analysis was made by comparing preoperative and latest Short Form 36 Health Survey scores. Height restoration was estimated by measuring vertebral height on lateral radiographs.

RESULTS: The mean age of patients was 63.5 years, mean duration of symptoms was 11 months, and mean follow-up was 7.4 months. There were no major complications related directly to use of this technique. On average, 34% of height lost at the time of fracture was restored. Asymptomatic cement leakage occurred at two (4%) of 55 levels. Significant improvement in SF36 scores occurred for Bodily Pain (23.2 to 55.4, P = .0008), Physical Function (21.3 to 50.6, P = .0010), Vitality (31.3 to 47.5, P = .010), and Social Functioning (40.6 to 64.8, P = .014).

CONCLUSION: Kyphoplasty was efficacious in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. Kyphoplasty is associated with early clinical improvement of pain and function as well as some restoration of vertebral body height.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. Terpos, O. Sezer, P. I. Croucher, R. Garcia-Sanz, M. Boccadoro, J. San Miguel, J. Ashcroft, J. Blade, M. Cavo, M. Delforge, et al. The use of bisphosphonates in multiple myeloma: recommendations of an expert panel on behalf of the European Myeloma Network Ann. Onc., August 1, 2009; 20(8): 1303 - 1317. [Abstract] [Full Text] [PDF]

				A. A Saad, M. Sharma, and G. M Higa Treatment of Multiple Myeloma in the Targeted Therapy Era Ann. Pharmacother., February 1, 2009; 43(2): 329 - 338. [Abstract] [Full Text] [PDF]

				B.A. Georgy Metastatic Spinal Lesions: State-of-the-Art Treatment Options and Future Trends AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1605 - 1611. [Abstract] [Full Text] [PDF]

				J. A. Katzel, P. Hari, and D. H. Vesole Multiple Myeloma: Charging Toward a Bright Future CA Cancer J Clin, September 1, 2007; 57(5): 301 - 318. [Abstract] [Full Text] [PDF]

				M. K. Shindle, W. Tyler, F. Edobor-Osula, M. J. Gardner, L. Shindle, J. Toro, and J. M. Lane Unsuspected Lymphoma Diagnosed with Use of Biopsy During Kyphoplasty J. Bone Joint Surg. Am., December 1, 2006; 88(12): 2721 - 2724. [Abstract] [Full Text] [PDF]

				H. S. Yeh and J. R. Berenson Treatment for myeloma bone disease. Clin. Cancer Res., October 15, 2006; 12(20): 6279s - 6284s. [Abstract] [Full Text] [PDF]

				A. G. Hadjipavlou, M. N. Tzermiadianos, P. G. Katonis, and M. Szpalski Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours J Bone Joint Surg Br, December 1, 2005; 87-B(12): 1595 - 1604. [Full Text] [PDF]

				A. Hiwatashi, R. Sidhu, R. K. Lee, R. R. deGuzman, D. T. Piekut, and P.-L. A. Westesson Kyphoplasty versus Vertebroplasty to Increase Vertebral Body Height: A Cadaveric Study Radiology, December 1, 2005; 237(3): 1115 - 1119. [Abstract] [Full Text] [PDF]

				E. Terpos and M.-A. Dimopoulos Myeloma bone disease: pathophysiology and management Ann. Onc., August 1, 2005; 16(8): 1223 - 1231. [Abstract] [Full Text] [PDF]

				J. M. Mathis, A. O. Ortiz, and G. H. Zoarski Vertebroplasty versus Kyphoplasty: A Comparison and Contrast AJNR Am. J. Neuroradiol., May 1, 2004; 25(5): 840 - 845. [Full Text] [PDF]

				K. L. Weber What's New in Musculoskeletal Oncology J. Bone Joint Surg. Am., May 1, 2004; 86(5): 1104 - 1109. [Full Text] [PDF]

				R. D. Rao and M. D. Singrakhia Painful Osteoporotic Vertebral Fracture: Pathogenesis, Evaluation, and Roles of Vertebroplasty and Kyphoplasty in Its Management J. Bone Joint Surg. Am., October 1, 2003; 85(10): 2010 - 2022. [Full Text]

				K. L. Weber and M. C. Gebhardt What's New in Musculoskeletal Oncology J. Bone Joint Surg. Am., March 31, 2003; 85(4): 761 - 767. [Full Text] [PDF]