Balloon Kyphoplasty in the Treatment of Neoplastic Spine Lesions: A Systematic Review

STUDY DESIGN: Systematic review. OBJECTIVES: To assess the efficacy of kyphoplasty in controlling pain and improving quality of life in oncologic patients with metastatic spinal disease and pathologic compression fractures of the spine. METHODS: A literature search through medical database was conducted (using PubMed, EMBASE, Cochrane, and LILACS) for randomized controlled trials comparing balloon kyphoplasty versus the traditional treatment for compression fractures of the spine due to metastatic disease. Two investigators independently assessed all titles and abstracts to select potential articles to be included. Inclusion criteria consisted of randomized controlled trials involving patients with pathologic compression fractures due to spinal metastasis or multiple myeloma treated with balloon kyphoplasty procedure as one of the study interventions, while the control group was any other treatment modality. The risk of bias in individual studies was assessed. RESULTS: Two studies, with a combined total of 181 patients, met inclusion criteria. Because of data heterogeneity, the meta-analysis was not possible, and individual analysis of studies was performed. There is moderate evidence that patients treated with balloon kyphoplasty displayed better scores for pain (Numeric Rating Scale), disability (Roland-Morris Disability Questionnaire), quality of life (Short Form–36 Health Survey), and functional status (Karnofsky Performance Status) compared with those undergoing the conventional treatment. Patients treated with kyphoplasty also have better recovery of vertebral height. CONCLUSIONS: This study concluded that balloon kyphoplasty could be considered as an early treatment option for patients with symptomatic neoplastic spinal disease, although further randomized clinical trials should be performed for improvement of the quality of evidence.