CLEVELANDIn research presented at the North American Spine
Society, Isador Lieberman, MD, described a new approach to repair of vertebral
compression fractures that may offer significant pain relief and other benefits
to myeloma patients.
The technique, kyphoplasty, involves using a cannula and small balloon to
pump up the collapsed vertebra, restoring much of its normal height and
creating a cavity that can then be filled with bone cement.
The kyphoplasty method appears quite effective at restoring lost vertebral
height and has little risk of cement extravasation, Dr. Lieberman said.
Vertebroplasty by injection of low-viscosity liquid cement into the unreduced
vertebral body is associated with cement extravasation rates as high as 65% in
metastases and 30% in osteoporotic fractures.
Dr. Lieberman, of the Department of Orthopedic Surgery, Cleveland Clinic
Foundation, had previously reported successful use of kyphoplasty in treatment
of painful osteoporotic vertebral compression fractures in 30 patients (Spine
That phase I study showed that kyphoplasty is safe and well tolerated in the
patient groups treated (24 with osteoporosis unresponsive to nonoperative
management, 6 with painful compression fractures from multiple myeloma), he
A significant amount of lost height was restored in 70% of the vertebral
bodies treated. Cement leakage occurred in only 6 vertebrae treated (8.6%) and
did not cause any clinical problems either immediately or during follow-up.