Evaluation of Incidentally Detected Pathology Results of Patients with Vertebral Fracture Treated by Vertebroplasty and Kyphoplasty: A Retrospective Study

• Published in: World neurosurgery Vol. 122; pp. e639 - e646
• Main Authors: Uzunoglu, Inan, Kaya, Ismail, Sucu, Hasan Kamil, Kizmazoglu, Ceren, Sevin, Ismail Ertan, Aydin, Hasan Emre, Rezanko, Turkan Atasever, Yuceer, Nurullah
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2019
• Subjects: Biopsy; Incidental; Infection; Kyphoplasty; Malignancy; Vertebroplasty; Infection; CT; Biopsy; MRI; PV; VCF; Malignancy; Vertebroplasty; PK; STIR; Incidental; Kyphoplasty
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.10.116

Vertebroplasty and kyphoplasty are minimally invasive techniques used to treat vertebral compression fractures. The etiology of vertebral compression fractures varies among patients. Although osteoporosis and trauma are major etiologic factors in patients with a vertebral compression fracture, unexpected results were found in 11 patients in the present study. The aim of the present retrospective study was to determine the incidentally detected pathology results of patients with vertebral fracture treated by vertebroplasty and kyphoplasty.
From February 2010 to November 2015, 616 patients with a vertebral compression fracture were treated by kyphoplasty and vertebroplasty at our institution. Vertebral biopsies were obtained from 533 patients during a vertebral augmentation technique. The average patient age was 62.4 years. Of the 616 patients, 388 were female and 228 were male. Histological evaluation of the biopsy specimens from the vertebral compression fractures was performed.
The biopsy results of 505 patients showed various stages of bone healing. Among these patients, malignancy was identified in 23 patients, and 43 patients had a history of malignancy. In 6 patients, an unsuspected malignancy was found, and 1 patient had Paget's disease. Infection was detected in 4 patients. In our study, the rate of unsuspected malignancy was 1.1%.
Tissue examination is useful and could reveal pathologic fractures. An incidentally detected biopsy result could change the treatment of patients; however, bone biopsy should be reserved for those patients whose preoperative radiological diagnosis raises suspicion of a nonosteoporotic etiology.