Kyphoplasty for the treatment of vertebral compression fractures in a cancer patient with neurological deficits and anterior vertebral wall destruction

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13 Citations (Scopus)

Abstract

Background: Percutaneous balloon kyphoplasty is an effective, minimally invasive procedure that is used to relieve pain and stabilize spine fractures caused by severe osteoporosis or osteolysis due to tumor metastasis. However, there remains a risk of bone cement leakage during and after kyphoplasty, especially in cases with severe vertebral wall destruction or neurological deficits. Objective: This article presents a case in which kyphoplasty was used to manage these complications in a woman with vertebral compression fractures caused by tumor metastasis. Design: Case report. Setting: Pain management clinic. Methods: The patient was a 76-year-old woman who had severe low back pain, lower extremity weakness, and cauda equina syndrome because of vertebral compression fracture and spinal metastasis with epidural involvement. The patient had a large bony defect in the vertebra that the bone filler device could pass freely through the anterior body wall. Nevertheless, kyphoplasty was successfully performed by using our new cement injection technique, which is a slow injection of the highly viscous bone cement, followed by a second injection 10 minutes later to allow the previously injected cement to harden. Results: The procedure significantly alleviated all symptoms. The day after the procedure, in the absence of additional pain medication, the pain had dropped dramatically to a numerical rating scale 3-4, and there was an improvement in motor function that allowed the patient to sit and go to the bathroom by herself. In addition, the voiding sensation had returned, which allowed the patient to defecate and urinate normally. Limitations: This report describes a single case report. Conclusion: Our new cement injection technique may allow balloon kyphoplasty to be safely and effectively performed in cancer patients with pathological vertebral compression fractures, even if there are large defects in the anterior vertebral wall and neurological deficits.

Original languageEnglish
Pages (from-to)539-544
Number of pages6
JournalPain Physician
Volume14
Issue number6
Publication statusPublished - 2011 Nov 1

Fingerprint

Kyphoplasty
Compression Fractures
Bone Cements
Injections
Neoplasms
Neoplasm Metastasis
Pain
Spine
Toilet Facilities
Polyradiculopathy
Therapeutics
Pain Clinics
Osteolysis
Pain Management
Low Back Pain
Osteoporosis
Lower Extremity
Bone and Bones
Equipment and Supplies

Keywords

  • Compression fractures
  • Kyphoplasty
  • Metastasis
  • Neurological deficits
  • Osteolysis
  • Polymethylmethacrylate

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Kyphoplasty for the treatment of vertebral compression fractures in a cancer patient with neurological deficits and anterior vertebral wall destruction",
abstract = "Background: Percutaneous balloon kyphoplasty is an effective, minimally invasive procedure that is used to relieve pain and stabilize spine fractures caused by severe osteoporosis or osteolysis due to tumor metastasis. However, there remains a risk of bone cement leakage during and after kyphoplasty, especially in cases with severe vertebral wall destruction or neurological deficits. Objective: This article presents a case in which kyphoplasty was used to manage these complications in a woman with vertebral compression fractures caused by tumor metastasis. Design: Case report. Setting: Pain management clinic. Methods: The patient was a 76-year-old woman who had severe low back pain, lower extremity weakness, and cauda equina syndrome because of vertebral compression fracture and spinal metastasis with epidural involvement. The patient had a large bony defect in the vertebra that the bone filler device could pass freely through the anterior body wall. Nevertheless, kyphoplasty was successfully performed by using our new cement injection technique, which is a slow injection of the highly viscous bone cement, followed by a second injection 10 minutes later to allow the previously injected cement to harden. Results: The procedure significantly alleviated all symptoms. The day after the procedure, in the absence of additional pain medication, the pain had dropped dramatically to a numerical rating scale 3-4, and there was an improvement in motor function that allowed the patient to sit and go to the bathroom by herself. In addition, the voiding sensation had returned, which allowed the patient to defecate and urinate normally. Limitations: This report describes a single case report. Conclusion: Our new cement injection technique may allow balloon kyphoplasty to be safely and effectively performed in cancer patients with pathological vertebral compression fractures, even if there are large defects in the anterior vertebral wall and neurological deficits.",
keywords = "Compression fractures, Kyphoplasty, Metastasis, Neurological deficits, Osteolysis, Polymethylmethacrylate",
author = "Lim, {Byung Gun} and Lee, {Jea Yeun} and Lee, {Mi Kyoung} and Lee, {Dong Kyu} and Kim, {Jun Suk} and Choi, {Sang Sik}",
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T1 - Kyphoplasty for the treatment of vertebral compression fractures in a cancer patient with neurological deficits and anterior vertebral wall destruction

AU - Lim, Byung Gun

AU - Lee, Jea Yeun

AU - Lee, Mi Kyoung

AU - Lee, Dong Kyu

AU - Kim, Jun Suk

AU - Choi, Sang Sik

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Background: Percutaneous balloon kyphoplasty is an effective, minimally invasive procedure that is used to relieve pain and stabilize spine fractures caused by severe osteoporosis or osteolysis due to tumor metastasis. However, there remains a risk of bone cement leakage during and after kyphoplasty, especially in cases with severe vertebral wall destruction or neurological deficits. Objective: This article presents a case in which kyphoplasty was used to manage these complications in a woman with vertebral compression fractures caused by tumor metastasis. Design: Case report. Setting: Pain management clinic. Methods: The patient was a 76-year-old woman who had severe low back pain, lower extremity weakness, and cauda equina syndrome because of vertebral compression fracture and spinal metastasis with epidural involvement. The patient had a large bony defect in the vertebra that the bone filler device could pass freely through the anterior body wall. Nevertheless, kyphoplasty was successfully performed by using our new cement injection technique, which is a slow injection of the highly viscous bone cement, followed by a second injection 10 minutes later to allow the previously injected cement to harden. Results: The procedure significantly alleviated all symptoms. The day after the procedure, in the absence of additional pain medication, the pain had dropped dramatically to a numerical rating scale 3-4, and there was an improvement in motor function that allowed the patient to sit and go to the bathroom by herself. In addition, the voiding sensation had returned, which allowed the patient to defecate and urinate normally. Limitations: This report describes a single case report. Conclusion: Our new cement injection technique may allow balloon kyphoplasty to be safely and effectively performed in cancer patients with pathological vertebral compression fractures, even if there are large defects in the anterior vertebral wall and neurological deficits.

AB - Background: Percutaneous balloon kyphoplasty is an effective, minimally invasive procedure that is used to relieve pain and stabilize spine fractures caused by severe osteoporosis or osteolysis due to tumor metastasis. However, there remains a risk of bone cement leakage during and after kyphoplasty, especially in cases with severe vertebral wall destruction or neurological deficits. Objective: This article presents a case in which kyphoplasty was used to manage these complications in a woman with vertebral compression fractures caused by tumor metastasis. Design: Case report. Setting: Pain management clinic. Methods: The patient was a 76-year-old woman who had severe low back pain, lower extremity weakness, and cauda equina syndrome because of vertebral compression fracture and spinal metastasis with epidural involvement. The patient had a large bony defect in the vertebra that the bone filler device could pass freely through the anterior body wall. Nevertheless, kyphoplasty was successfully performed by using our new cement injection technique, which is a slow injection of the highly viscous bone cement, followed by a second injection 10 minutes later to allow the previously injected cement to harden. Results: The procedure significantly alleviated all symptoms. The day after the procedure, in the absence of additional pain medication, the pain had dropped dramatically to a numerical rating scale 3-4, and there was an improvement in motor function that allowed the patient to sit and go to the bathroom by herself. In addition, the voiding sensation had returned, which allowed the patient to defecate and urinate normally. Limitations: This report describes a single case report. Conclusion: Our new cement injection technique may allow balloon kyphoplasty to be safely and effectively performed in cancer patients with pathological vertebral compression fractures, even if there are large defects in the anterior vertebral wall and neurological deficits.

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