A surgical technique appears to offer quick and effective relief for debilitating spinal fractures often suffered by patients with metastatic cancer.

Many patients with multiple myeloma, or those whose cancer has spread beyond the initial tumor site, suffer compression fractures in their spine. This is partly because the spine is one of the most common sites for metastatic spread of the disease, making the vertebrae brittle and at risk for fractures. Widely-used cancer treatments such as corticoid treatment, hormone therapy, radiation therapy can also have a weakening effect on bone and increase the risk for fractures in these patients.

Leonard Bastian from Klinikum Leverkusen in German led an international trial testing a new technique to treat these compression fractures, called balloon kyphoplasty, a minimally invasive surgical procedure.

To perform the procedure, a surgeon inserts a small orthopedic balloon through a 1 cm incision into the fractured vertebra. Inflation of the balloon can restore the shape and height of the vertebrae. The balloon is then deflated and removed and a precise amount of quick-setting bone cement is injected in the vertebral body restoring the shape and strength of the vertebrae.

A trial assessed 134 patients randomly assigned to either balloon kyphoplasty ( 70 patients ) or non-surgical management ( 64 ).

Those who had the surgery showed improvements in a questionnaire designed to measure their level of disability at one month after surgery. They also experienced a significant improvement in back pain one week after surgery, while those who received non-surgical management saw no improvement.

After one month, patients in the non-surgical arm of the study were allowed to receive balloon kyphoplasty. Thirty-eight chose to do so. All patients who underwent balloon kyphoplasty reported sustained improvements in quality of life for a year after treatment.

Source: ESMO Meeting, 2010

XagenaMedicine2010


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