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RADIOFREQUENCY KYPHOPLASTY (RFK) FOR THE TREATMENT OF VERTEBRAL COMPRESSION FRACTURES AS A RESULT OF MULTIPLE MYELOMA 2011

Interventional Spine

Eren, Erdem, M.D.
Sertac, Akdol, M.D., Non ASSR Member
Adewumi, Amole, M.D., Non ASSR Member
Katy, Fryar, R.N., Non ASSR Member
Robert, W, Eberle, M.S., Non ASSR Member

Paper/Non-Mentor

Purpose

To investigate the safety and efficacy of Radiofrequency Kyphoplasty (RFK) in patients with malignant vertebral compression fractures (VCFs).

Methods & Materials

Between December, 2008 and May 2009, a consecutive series of 66 RFK procedures were performed by the author for VCF secondary to multiple myeloma. The novel technique of RFK incorporates the use of navigational osteotomes for controlled cavity creation, RF energy to enhance the PMMA into UHV-PMMA which allows for longer working times (up to 35 minutes), and the ability to perform intermittent delivery with up to 90 second pauses for trabecular interdigitation, intravertebral polymerization and vertebral height restoration. Pre- and post-operatively, a standard 10-point visual analog scale (VAS) was utilized to assess back pain. Pain medication use and activity categories were defined and monitored for changes before and after RFK. All patients were followed for six-months post-operatively.

Results

At six-months post-operatively, significant improvement in pain, activity and narcotic use was observed (p < 0.001). There were no pulmonary or neurological complications, and one patient with radiographic evidence of asymptomatic leakage of PMMA into the vertebral disc space.

Conclusion

We report optimum safety and efficacy results in the treatment of malignant VCFs with a novel RFK technique in which controlled delivery of an ultra-high viscosity PMMA is utilized for fracture stabilization. The deposition of PMMA with RFK is predictable and uniform, and can be performed without the PMMA handling constraints that may be encountered with VP and BKP. The safety and efficacy we observed and reported achieved equivalency with other methods of treatment for VCF stabilization.

References/Financial Disclosures

DFine Inc.

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