DOS 2018

194 · DOS Abstracts Vertebroplasty or kyphoplasty as palliative treatment for cancer-related vertebral compression fractures: a systematic review Simon Thorbjørn Sørensen, Andreas Ole Kirkegaard, Leah Carreon , Rikke Rousing, Mikkel Østerheden Andersen Center for Spine Surgery & Research, Middelfart Hospital Background: Analgesics and bed rest is often not an effective treatment in cancer patients with painful vertebral fractures due to spinal metastasis. Percutaneous vertebroplasty (PVP) and kyphoplasty (KP) has been reported to provide rapid pain relief compared to other conventional treatment options. Purpose / Aim of Study: To perform a systematic review evaluating the ef- fectiveness and safety of vertebral augmentation for malignant vertebral com- pression fractures (VCFs). Materials and Methods: Using PRISMA guidelines, studies on PVP or KP for VCFs in patients with malignant spinal lesions published between January 1, 2000 and January 3, 2018 were identified by combining the results of a report by Health Quality Ontario with an updated literature search. Data on patient demographics, outcome measures including Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI), Karnofsky Performance Score (KPS), and com- plications were extracted from eligible studies. Findings / Results: The review identified 2 RCTs, 16 prospective studies, 44 retrospective studies, and 25 case series for a patient sample size of 3426. At the earliest follow- up, pain improved from 7.48 to 3.00 with PVP, and from 7.05 to 2.96 with KP. ODI improved from 74.68 to 17.73 with PVP, and from 66.02 to 34.73 with KP. KPS improved from 66.99 to 80.28. Cement leakage was seen in 38.4% and 16.3% of patients treated with PVP and KP respectively. Symptomatic complications (N=43) were rare. Conclusions: This review showed clinically relevant improvements in pain, ODI, and KPS in patients with VCFs due to malignancy treated with either PVP or KP. Cement leakage is common, but rarely symptomatic. PVP and KP are safe and effective palliative procedures for painful VCFs in patients with malignant spinal lesions. 135.