North Shore University Hospital is the first center in the Eastern United States – and the second nationally – to perform combined kyphoplasty intraoperative radiation therapy (IORT) for spinal metastasis.
Andre Hayden, 47, of Wheatley Heights, NY, received the treatment due to Stage 4 colon cancer that metastasized to his spine, causing debilitating pain even after completing a course of spine external irradiation. The minimally invasive joint procedure was performed on November 3 by neurosurgeon Ahmad Latefi, DO, and radiation oncologist Maged Ghaly, MD.
Spinal metastases develop in 40 percent of patients diagnosed with cancer. One in five patients with spinal metastasis present with unstable lesions and require a surgical intervention with a procedure called kyphoplasty.
“For cancer patients with spinal metastasis, it is often recommended that after surgery to stabilize the spine, most of these patients will be offered short-course of conventional external beam radiation therapy (cEBRT), which has been associated with short-term pain control and low rates of complete response to pain,” said Dr. Ghaly. “Furthermore, approximately 20 percent of patients will suffer pain progression following cEBRT, requiring treatment.”
In Mr. Hayden’s case, he suffered from a painful, pathologic vertebral fracture caused by the tumor. A second course of external irradiation would result in spine fracture progression.
“Kypho-IORT is a novel approach to combine kyphoplasty, a minimally invasive procedure with a single dose of intraoperative radiation therapy for the treatment of unstable or potentially unstable spinal cord metastases, even if patients had prior spine radiation,” said Dr. Latefi. “This integrated palliative treatment option improves the patient’s quality of life with quicker pain relief and without interrupting their systemic therapy.”
During the first part of the procedure, Dr. Latefi made a small incision in the spine and then inserted an Intrabeam needle applicator, manufactured by Carl Zeiss Meditec. Dr. Ghaly performed the IORT procedure by delivering radiation treatment directly into the tumor, preserving the spinal cord and surrounding tissue.
During the next stage kyphoplasty, Dr. Latefi placed a catheter through the small incision. A balloon placed at the tip of the catheter was inflated to restore the height of the vertebrae. A cement-like substance was injected into the spine, fortifying the vertebrae against future collapse.
After the procedure, Mr. Hayden was discharged the same day and was able to resume his daily activities.
For more information about kyphoplasty, click here. For more information, about IORT, click here. To make an appointment to see if you are an eligible candidate for combined kyphoplasty IORT, call Dr. Latefi at 516-773-7737 or Dr. Ghaly at 516-321-3000.