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 26:1631-1638, 2001).
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 said.
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.