Congress Abstracts 2005

10

UNDERSTANDING KYPHOPLASTY AS TREATMENT FOR VERTEBRAL COMPRESSION FRACTURES. Mandy Sullivan, RN, H. Lee Moffitt Cancer Center, Tampa, FL.

Kyphoplasty, a treatment for vertebral compression fractures is a viable pain management option for some patients. Familiarity with the type scope of approaches to pain management is imperative for Oncology Nurses.

Vertebral compression fractures and resultant pain is a significant issue for cancer patients. Both disease itself (breast, lung, and prostate cancers, and osteoporosis) and cancer treatment can compromise integrity of the vertebra. For example, the incidence of compression fractures in patients with multiple myeloma is 50%–70%. The vertebral body collapses with a compression fracture, resulting in shortening of the spine and characteristic kyphosis, or humped over appearance. The intent of kyphoplasty is to relieve fracture-induced pain. Kyphoplasty involves fluoroscopy-guided introduction of balloon-like inflatable bone tamps (IBT) into the collapsed vertebral body. Inflation of the IBT results in restoration of the vertebral body height. The IBT is removed and resultant cavity filled with bone cement. Kyphoplasty is typically performed as an outpatient or overnight stay procedure. Kyphoplasty is similar to another procedure of introducing bone cement into the vertebral body (vertebroplasty), but differs in that kyphoplasty uses the IBT. Kyphoplasty results in fewer complications than traditional vertebroplasty, particularly less leakage of bone cement. Clinical trials demonstrate both pain relief and improvement in function as outcomes of the procedure.

The purpose of this presentation is to educate Oncology Nurses about an option available to treat painful vertebral compression fractures in cancer patients.

A general overview of the procedure will be depicted. Criteria for patient selection for kyphoplasty will be reviewed. Nursing priorities of care for the patient undergoing kyphoplasty will be identified. A case study will be presented.

Oncology nurses who view this presentation will gain a basic understanding of kyphoplasty, its use in management of pain resulting from vertebral compression fractures, and nursing priorities for patients undergoing this procedure.

Oncology Nurses, functioning as patient advocates, need to be familiar with the spectrum of pain management options for their patients. Understanding when kyphoplasty might benefit a patient with vertebral compression fractures could result in earlier intervention and improved pain control for those patients.