Abstract
Introduction
We aimed to investigate the clinical outcomes of percutaneous kyphoplasty (PKP) for
spinal metastases in older adult patients with comorbidities.
Materials and Methods
Ninety-two older adults (age ≥ 60 years) with spinal metastases who underwent 148
PKP procedures were retrospectively analyzed. Tokuhashi scores, Tomita scores, age-adjusted
Charlson Comorbidity Index (aCCI) scores, and American Society of Anesthesiologists
(ASA) scores were evaluated before the procedure. The visual analog scale (VAS), Oswestry
Disability Index (ODI), vertebral body height (VBH), and quality of life (QoL) were
used to assess the efficacy of the procedure. Clinical safety was evaluated based
on periprocedural complications.
Results
Tokuhashi scores and Tomita scores were 7.3 ± 4.0 and 5.8 ± 2.1, respectively. Excluding
cancer-related factors, twelve patients (13.0%) had aCCI scores ≥4. Forty-three patients
(46.7%) had ASA status ≥ III. Compared to preoperative status, average VAS scores,
ODI scores, VBH variation, and QoL scores significantly improved at each follow-up
examination point after PKP (p < 0.001). No major complications occurred, nor was there decompensation of comorbidities
in the perioperative period. Seventeen segments (11.5%) of twelve patients (13.0%)
suffered bone cement leakage. Among them, one patient suffered intercostal neuralgia
cured by steroid injection, and the other patient suffered hyperesthesia, which disappeared
after taking gabapentin (0.3 g, bid) for five weeks. Another minor complication of
local hematoma occurred in one patient, which spontaneously resolved without surgical
intervention.
Discussion
PKP serves as a safe approach to provide significant pain relief, vertebral body height
restoration, and QoL improvements for spinal metastases in older adults, independent
of underlying disease.
Keywords
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Article info
Publication history
Published online: December 06, 2022
Accepted:
November 30,
2022
Received in revised form:
November 18,
2022
Received:
August 5,
2022
Identification
Copyright
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