Kyphoplasty in the Early Oncologic Diagnosis and Treatment of Vertebral Fractures: A Clinical Study

Özet

AIM: To elucidate the characteristics of kyphoplasty in correlation with spinal metastasis.MATERIAL and METHODS: Data of patients treated by kyphoplasty between January 2017 and December 2019 were reviewedretrospectively. Preoperative prophylactic antibiotics and low-molecular-weight heparin injections were performed. Postoperativefollow-up was conducted at least 24 hours after the procedure. All patients were treated under sedoanalgesia. Bone biopsies werecollected from all patients.RESULTS: One hundred ninety-nine vertebra fractures were treated in 130 patients. The mean age of the patients was 65.27 ± 8.79years (18–90 years) and 66 patients were male (50.7%). Forty-five patients had osteoporosis, six patients showed malignancy, andosteomyelitis was found in three patients, while the others’ presentations were secondary to trauma. Most commonly, the L1 (n=59),Th12 (n=45), and L2 (n=34) levels were found to develop vertebral fractures. Forty patients had multiple levels of vertebral fracture,with a higher rate of osteoporosis (n=24; 60%). Three patients showed undiagnosed oncologic disease with an initial diagnosisof acute fracture following minor trauma, while the primary oncologic diagnosis was established by bone biopsy taken during theroutine procedure in each procedure (e.g., plasmacytoma, lymphoma, adenocarcinoma of the lung). None of the patients developedan infection due to kyphoplasty, permanent neuromotor deficit, or mortality. The mean postoperative hospital length of stay was1.6 days.CONCLUSION: Bone biopsy should be performed to diagnose early spinal metastases. Although an accurate bone biopsy may notbe obtained from some patients, particularly from those with osteoporosis, performing bone biopsy during the procedure does notcause time loss or any other complications, and protects the surgeon from possible medicolegal problems.