Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Abstract

Percutaneous vertebroplasty (PVP) has been shown to release spinal pain and stabilize the vertebral body. PVP is suggested as an alternative treatment in spinal metastasis. Although cervical metastases is less prevalent than thoracic and lumbar spine, PVP procedure in cervical vertebrae remains technical challenging. We retrospectively analyzed the data from patients (n = 9) who underwent PVP using anterolateral approach to treat severe neck pain and restricted cervical mobility from metastatic disease. Patients were rated using modified Tokuhashi score and Tomita score before the procedure. Visual analog scale (VAS), neck disability index (NDI), analgesic use, and imaging (X-ray or CT) were evaluated before PVP and 3 days, 3 months, and 6 months after PVP. All patients were in late stage of cancer evaluated using modified Tokuhashi and Tomita score. The cement leakage rate was 63.6% (14 of the 22 vertebrae) with no severe complications. VAS, NDI, and analgesic use were significantly decreased 3 days after the procedure and remained at low level until 6 months of follow-up. Our result suggested PVP effectively released the pain from patients with cervical metastasis. The results warrant further clinical investigation.

Transoral Vertebroplasty for Osteolytic C2 Metastasis: Report of 2 Cases

“…Several studies indicate that cervical VP has a high technical success rate combined with a low complication rate, while providing immediate pain relief, that lasts for a long-term; in addition, the use of analgesic drugs is reduced 1,3,11,13) . Our patient also showed dramatic pain reduction after the procedure, which continued until he died due to pneumonia aggravation 1 month later.…”

Surgical treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children (сlinical observations, preliminary results)

“…Данные опции позволяют выполнять эмуляцию компьютерной томографии и отслеживать в ре-альном времени направление и глубину введения пункционной иглы с помощью мультипланарных плоскостных и объемных реконструкций [8,14]. ПВ может быть выполнена из открытого доступа, повышающего эффективность и безопасность манипуляции [15]. Это, конечно, в большей мере относится к выполнению вертебропластики в шейно-грудном переходном отделе позвоночника.…”

“…Это затрудняет процесс контроля за пункцией позвонка иглой, тем самым повышается риск развития осложнений. В связи с вышесказанным ПВ на данном уровне рекомендуют выполнять из открытого переднебокового доступа [15].…”

Treatment of spine metastases in cancer: a review

“…28,31,57 Minimally-invasive techniques can improve spine stabilization and reduce the morbidity of spine metastases. 1,30,34,[58][59][60][61][62][63][64] It is clear that there are several treatments available for spine metastases but not every method is suitable for every patient. The different methodologies have their own characteristics, offering both advantages and disadvantages according to the clinical situation ( Table 1).…”

“…63 The use of percutaneous vertebroplasty in cervical metastasis treatment through the anterolateral approach is not indicated in extremely overweight patients and in patients that find it difficult to maintain a cervical extended position. 62 Cement leakage, spinal cord or radicular compression and pulmonary embolism are potential complications. 63 Percutaneous kyphoplasty is a variant of percutaneous vertebroplasty in which kyphon balloons are used to restore the height of the vertebra.…”