Advertisement

Vertebroplasty, Kyphoplasty, and Sacroplasty

  • Dawood Sayed
  • Shervin Razavian
Chapter

Abstract

Vertebral augmentation, which includes vertebroplasty and kyphoplasty, is an effective therapy for those suffering from pathological vertebral body compression fractures. Several variant techniques have been described, but all essentially involve an image-guided injection of PMMA into the compressed vertebrae. Performed in a minimally invasive manner, vertebral augmentation can provide rapid pain relief with very little recovery. The burden of bony metastatic disease to the spine is significant in many forms of cancer. Risks of vertebral augmentation include nerve damage, bleeding, infection, and cement extravasation. Recent advances with kyphoplasty and cavity creation prior to PMMA injection have led to an increased safety profile when compared to standard vertebroplasty.

Keywords

Vertebral augmentation Vertebroplasty Kyphoplasty Sacroplasty Bone metastasis Pathological vertebral body fracture Cancer-related pain 

References

  1. 1.
    Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie. 1987;33(2):166–8.PubMedGoogle Scholar
  2. 2.
    Weinstein JN. Balancing science and informed choice in decisions about vertebroplasty. N Engl J Med. 2009;361(6):619–21.CrossRefGoogle Scholar
  3. 3.
    Berenson J, Pflugmacher R, Jarzem P, Zonder J, Schechtman K, Tillman JB, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre randomised controlled trial. Lancet Oncol. 2011;12(3):225–35.CrossRefGoogle Scholar
  4. 4.
    Coleman RE. Skeletal complications of malignancy. Cancer. 1997;80(8 Suppl):1588–94.CrossRefGoogle Scholar
  5. 5.
    Chew C, Craig L, Edwards R, Moss J, O’Dwyer PJ. Safety and efficacy of percutaneous vertebroplasty in malignancy: a systematic review. Clin Radiol. 2011;66(1):63–72.CrossRefGoogle Scholar
  6. 6.
    Chew C, Ritchie M, O’Dwyer PJ, Edwards R. A prospective study of vertebroplasty in patients with myeloma and spinal metastasis. Clin Radiol. 2011;66(12):1193–6.CrossRefGoogle Scholar
  7. 7.
    Aaron AD. The management of cancer metastatic to bone. J Am Med Assoc. 1994;272(15):1206–9.CrossRefGoogle Scholar
  8. 8.
    Lee B, Franklin I, Lewis JS, Coombes RC, Leonard R, Gishen P, et al. The efficacy of percutaneous vertebroplasty for vertebral metastasis associated with solid malignancies. Eur J Cancer. 2009;45(9):1597–602.CrossRefGoogle Scholar
  9. 9.
    Goblirsch MJ, Zwolak PP, Clohisy DR. Biology of bone cancer pain. Clin Cancer Res. 2006;12(20 Pt 2):6231s–5s.CrossRefGoogle Scholar
  10. 10.
    Tong D, Gillick L, Hendrickson FR. The palliation of symptomatic osseous metastases: final results of the study by the radiation therapy oncology group. Cancer. 2. Allan JM, Travis LB. Mechanisms of therapy related carcinogenesis. Nat Rev Cancer 2005;5(12):943–955. r 1982;50(5):893–899.Google Scholar
  11. 11.
    Rose PS, Laufer I, Boland PJ, Hanover A, Bilsky MH, Yamada J, et al. Risk of fracture after single fraction image-guided intensity-modulated radiation therapy to spinal metastasis. J Clin Oncol. 2009;27(30):5075–9.CrossRefGoogle Scholar
  12. 12.
    Bentzen SM. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nat Rev Cancer. 2006;6(9):703–13.CrossRefGoogle Scholar
  13. 13.
    Allan JM, Travis LB. Mechanisms of therapy related carcinogenesis. Nat Rev Cancer. 2005;5(12):943–55.CrossRefGoogle Scholar
  14. 14.
    Jefferies S, Rajan B, Ashley S, Traish D, Brada M. Haematological toxicity of cranio-spinal irradiation. Radiother Oncol. 1998;48(1):23–7.CrossRefGoogle Scholar
  15. 15.
    Coyle N, Adelhardt J, Foley KM, Portenoy RK. Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manag. 1990;5(2):83–93.CrossRefGoogle Scholar
  16. 16.
    Tseng YY, Lo YL, Chen LH, Lai PL, Yang ST. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of pain induced by metastatic spinal tumor. Surg Neurol. 2008;70(Suppl 1):S1 78–83.Google Scholar
  17. 17.
    Peters KR, Guiot BH, Martin PA, Fessler RG. Vertebroplasty for osteoporotic compression fractures: current practice and evolving techniques. Neurosurgery. 2002;51(5 Suppl):S96–103.PubMedGoogle Scholar
  18. 18.
    Hentschel SJ, Burton AW, Fourney DR, Rhines LD, Mendel E. Percutaneous vertebroplasty and kyphoplasty performed at a cancer center: refuting proposed contraindications. J Neurosurg Spine. 2005;2(4):436–40.CrossRefGoogle Scholar
  19. 19.
    Amar AP, Larsen DW, Teitelbaum GP. Percutaneous carotid angioplasty and stenting with the use of gadolinium in lieu of iodinated contrast medium: technical case report and review of the literature. Neurosurgery. 2001;49(5):1262–6.PubMedGoogle Scholar
  20. 20.
    Fenton DS, Czervionke LF. Image-guided spine intervention. Philadelphia: Saunders; 2003.Google Scholar
  21. 21.
    Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361(6):557–68.CrossRefGoogle Scholar
  22. 22.
    Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL. Percutaneous vertebroplasty: indications, technique, and results. Radiographics. 2003;23(2).  https://doi.org/10.1148/rg.e10.CrossRefGoogle Scholar
  23. 23.
    Chen KY, Ma HI, Chiang YH. Percutaneous transpedicular vertebroplasty with polymethyl methacrylate for pathological fracture of the spine. J Clin Neurosci. 2009;16(10):1300–4.CrossRefGoogle Scholar
  24. 24.
    San Millan Ruiz D, Burkhardt K, Jean B, Muster M, Martin JB, Bouvier J, et al. Pathology findings with acrylic implants. Bone. 1999;25(2 Suppl):85s–90s.CrossRefGoogle Scholar
  25. 25.
    Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine. 2001;26(14):1511–5.CrossRefGoogle Scholar
  26. 26.
    Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg. 2003;98(1 Suppl):21–30.PubMedGoogle Scholar
  27. 27.
    Furman MB, Lee TS, Berkwitz L. Atlas of image-guided spinal procedures. Philadelphia: Saunders; 2012.Google Scholar
  28. 28.
    Goetz MP, Callstrom MR, Charboneau JW, Farrell MA, Maus TP, Welch TJ. Percutaneous image-guided radiofrequency ablation of painful metastasis involving bone: a multicenter study. J Clin Oncol. 2004;22(2):300–6.CrossRefGoogle Scholar
  29. 29.
    Shah RV. Sacral kyphoplasty for the treatment of painful sacral insufficiency fractures and metastases. Spine J. 2012;12(2):113–20.CrossRefGoogle Scholar
  30. 30.
    Zhang J, Wu CG, Gu YF, Li MH. Percutaneous sacroplasty for sacral metastatic tumors under fluoroscopic guidance only. Korean J Radiol. 2008;9(6):572–6.CrossRefGoogle Scholar
  31. 31.
    Cotten A, Dewatre F, Cortet B, Assaker R, Leblond D, Duquesnov B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology. 1996;200(2):525–30.CrossRefGoogle Scholar
  32. 32.
    Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. Am J Neuroradiol. 2006;27(1):217–23.PubMedGoogle Scholar
  33. 33.
    Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J. 2006;16(8):1085–100.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Dawood Sayed
    • 1
  • Shervin Razavian
    • 2
  1. 1.University of Kansas Medical Center, Department of Anesthesiology and Pain MedicineKansas CityUSA
  2. 2.Anesthesia Associates of Kansas CityOverland ParkUSA

Personalised recommendations