Turkish Neurosurgery
Kyphoplasty in the Early Oncologic Diagnosis and Treatment of Vertebral Fractures: A Clinical Study
Yener Akyuva1, Benan Baysoy1, Eyüp Can Savrunlu1, Gülseli Berivan Sezen1, Osman Boyalı1, Halil Can2, Erdinç Civelek1, Serdar Kabataş1
1University of Health Sciences Gaziosmanpaşa Training and Research Hospital, Neurosurgery, Istanbul,
2Istanbul Biruni University Medicine Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.29550-20.2

Aim:Spinal metastases may cause acute vertebral fracture.Compression fractures may develop in the metastatic vertebra corpus after minor trauma.This retrospective clinical study sought to elucidate the characteristics of kyphoplasty in correlation with spinal metastasis.Material and Methods:Data of patients treated by kyphoplasty between January2017 and January2020 were reviewed retrospectively.Preoperative prophylactic antibiotics and low-molecular-weight-heparin injections were performed.All patients were treated under sedoanalgesia.Bone biopsies were collected from all patients.Results:199vertebra fractures were treated in 130patients.The mean age of the patients was 65.27±8.79 years(18–90years) and 66patients were male(50.7%).45patients had osteoporosis,six patients showed malignancy, and osteomyelitis 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 diagnosis of acute fracture following minor trauma,while the primary oncologic diagnosis was established by bone biopsy taken during the routine procedure in each procedure (e.g.,plasmacytoma,lymphoma,adenocarcinoma of the lung).None of the patients developed an infection due to kyphoplasty,permanent neuromotor deficit,or mortality.The mean postoperative hospital length of stay was1.6days.Conclusion:Bone biopsy should be performed to diagnose early spinal metastases. Although an accurate bone biopsy may not be obtained from some patients, particularly from those with osteoporosis, performing bone biopsy during the procedure does not cause time loss or any other complications and protects the surgeon from possible medicolegal problems.

Corresponding author : Yener Akyuva