Incidence of unexpected positive histology in kyphoplasty.
OBJECTIVE
Kyphoplasty and vertebroplasty have become one of the most frequent surgical procedures in the treatment of vertebral compression fractures. Often, the cause of compression fractures is lowered bone mineral density as in osteoporosis. In the differential workup, also pathologic vertebral compression fractures need to be ruled out. Importantly, imaging techniques alone cannot safely differentiate between invasive lymphatic and osteoporotic vertebral fracture. Our goal was to identify the degree of unexpected positive histology in kyphoplasty for presumed osteoporotic vertebral compression fracture.


METHODS
We retrospectively analyzed all kyphoplasties performed between 2007 and 2015 at our institution. The data were acquired by reviewing our medical documentation system. The data analysis was done using Microsoft Excel. The statistical analysis was done using the Chi-squared test.


RESULTS
We performed 130 kyphoplasties/vertebroplasties. A biopsy was taken in 97 (74.6%) cases. In 10 (10.3%) cases, the histology revealed a pathological fracture. From these patients, only in 3 (30%) cases, a positive histology was not expected. Meaning that there was no history of cancer and the radiological findings presumed an osteoporotic fracture.


CONCLUSIONS
Therefore, we could demonstrate that the incidence of unexpected positive histology in vertebral compression fracture treated with kyphoplasty is significant (3.1%). As a conclusion, if a kyphoplasty is performed due to assumed osteoporotic vertebral compression fracture, a biopsy should be taken to safely rule out a pathological fracture caused by lymphatic bony invasion.
['Nowak|Stephan|S|http://orcid.org/0000-0002-0856-6768', 'Müller|Jonas|J|', 'Schroeder|Henry W S|HWS|', 'Müller|Jan Uwe|JU|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D050815:Fractures, Compression D005598:Fractures, Spontaneous D006801:Humans D015994:Incidence D033162:Incidental Findings D058498:Kyphoplasty D008297:Male D008875:Middle Aged D058866:Osteoporotic Fractures D012189:Retrospective Studies D016103:Spinal Fractures D013125:Spinal Neoplasms D013131:Spine D055815:Young Adult
Kyphoplasty Osteoporosis Vertebral fracture Lymphoma