New work from Brazil has added to the literature on the use of balloon kyphoplasty. The study, “Balloon Kyphoplasty in the Treatment of Neoplastic Spine Lesions: A Systematic Review,” appears in the April 24, 2018 edition of the Global Spine Journal.
New Study: Kyphoplasty for Neoplastic Spine Lesions?
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Co-author Nelson Astur, M.D., M.Sc., orthopedic surgeon with the Santa Casa de Sao Paulo School of Medical Sciences, told OTW, “As balloon kyphoplasty was routinely used in our institution for osteoporotic vertebral compression fractures, its use was not clear for treatment of spinal pain due to vertebral metastasis. Since we found no sufficient evidence to base this treatment modality, we started a systematic review of the literature.”
The authors wrote, “A literature search through medical database was conducted (using PubMed, EMBASE, Cochrane, and LILACS) for randomized controlled trials comparing balloon kyphoplasty versus the traditional treatment for compression fractures of the spine due to metastatic disease.”
“Inclusion criteria consisted of randomized controlled trials involving patients with pathologic compression fractures due to spinal metastasis or multiple myeloma treated with balloon kyphoplasty procedure as one of the study interventions, while the control group was any other treatment modality.”
Dr. Astur told OTW, “Although there are only two clinical trials comparing balloon kyphoplasty to treat vertebral metastasis, we found sufficient evidence that it improves pain and quality of life in oncologic patients with spinal metastasis or multiple myeloma. Balloon kyphoplasty can be considered as an early tool for palliative treatment and pain improvement of the neoplastic spine.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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