2005
DOI: 10.1007/s00270-004-0159-5
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Percutaneous Cervical Vertebroplasty in a MultifunctionalImage-Guided Therapy Suite: Hybrid Lateral Approach to C1 andC4 Under CT and Fluoroscopic Guidance

Abstract: A 76-year-old patient suffering from two painful osteolytic metastases in C1 and C4 underwent percutaneous vertebroplasty by a hybrid technique in a multi-functional image-guided therapy suite (MIGTS). Two trocars were first placed into the respective bodies of C1 and C4 under fluoroscopic computed tomography guidance using a lateral approach. Thereafter, the patient was transferred on a moving table to the digital subtraction angiography unit in the same room for implant injection. Good pain relief was achiev… Show more

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Cited by 32 publications
(23 citation statements)
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“…As reported in biomechanical studies (8), even a small volume of cement guarantees the restoration of vertebral body integrity and consequent pain relief. In this case, a complete and lasting cervical pain remission was obtained with a total injection of 2.5 mL of bone cement; this is consistent with the previously described cases (4,5).…”
supporting
confidence: 89%
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“…As reported in biomechanical studies (8), even a small volume of cement guarantees the restoration of vertebral body integrity and consequent pain relief. In this case, a complete and lasting cervical pain remission was obtained with a total injection of 2.5 mL of bone cement; this is consistent with the previously described cases (4,5).…”
supporting
confidence: 89%
“…Injection of acrylic cement was proved to be effective in pain relief by stabilizing the vertebral body (2); this clinical outcome could also be achieved in difficult cervical vertebrae (3) even if percutaneous vertebroplasty on the body of C1 was previously reported in only two cases (4,5). Metastases located on C1 needing stabilization are extremely rare, and the most common surgical option for atlas neoplasms (reported in few case reports and case series most frequently for primary tumors such as chordoma or meningioma) is resection eventually followed by occipitocervical fusion (6).…”
mentioning
confidence: 97%
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“…Considering the limited life expectancy, 15,16 we abandoned occipitocervical fusion to preserve head mobility. Percutaneous cervical vertebroplasty would have been another option that has been performed via different approaches in selected patients with osteolytic tumors; 1,3,4,7,8,10,17 however, this technique is challenging, and violation of the vertebral artery as well as cement extravasation into the vertebral artery or spinal canal can occur. Preoperatively, we assumed a gap in the cortical bone between the tumor and the spinal canal, which implies a higher risk for intraspinal cement extravasation.…”
Section: Discussionmentioning
confidence: 99%