In the Journals

Balloon kyphoplasty technique may lead to distinct tumor-spread pattern

Although balloon kyphoplasty has been shown to be effective for the treatment of vertebral compression fractures, researchers have found a distinct tumor-spread pattern that appears to be related to the procedure.

The researchers analyzed two cases of contiguous tumor spread following single-level balloon kyphoplasty. They observed MRI-confirmed tumor spread into adjacent vertebral levels at 4 weeks following balloon kyphoplasty in one case and at 2 months afterward in the other; however, this was determined to not be a true tumor spread.

The researchers hypothesized that the observed pattern could be a result of two synergistic mechanisms, the first of which they linked to the physical displacement of soft tumor tissue, which is pushed past the vertebral bony boundaries through defects in the fractured cortex during the procedure. The second potential cause may be the increase in intravertebral pressure generated during balloon inflation and/or the injection of cement, which leads to venous extravasation.

To potentially avoid this complication, the researchers recommended slower inflation of the balloon, which would circumvent any sudden pressure increased within the vertebral body; underinflation of the balloon; or smaller amounts of cement used for injections, which may help reduce the potential for displacement of the tumor.

Disclosures: Saghal and Smith have received honoraria for past educational seminars directly related to balloon kyphoplasty.

Although balloon kyphoplasty has been shown to be effective for the treatment of vertebral compression fractures, researchers have found a distinct tumor-spread pattern that appears to be related to the procedure.

The researchers analyzed two cases of contiguous tumor spread following single-level balloon kyphoplasty. They observed MRI-confirmed tumor spread into adjacent vertebral levels at 4 weeks following balloon kyphoplasty in one case and at 2 months afterward in the other; however, this was determined to not be a true tumor spread.

The researchers hypothesized that the observed pattern could be a result of two synergistic mechanisms, the first of which they linked to the physical displacement of soft tumor tissue, which is pushed past the vertebral bony boundaries through defects in the fractured cortex during the procedure. The second potential cause may be the increase in intravertebral pressure generated during balloon inflation and/or the injection of cement, which leads to venous extravasation.

To potentially avoid this complication, the researchers recommended slower inflation of the balloon, which would circumvent any sudden pressure increased within the vertebral body; underinflation of the balloon; or smaller amounts of cement used for injections, which may help reduce the potential for displacement of the tumor.

Disclosures: Saghal and Smith have received honoraria for past educational seminars directly related to balloon kyphoplasty.