Safety and effectiveness of cervical vertebroplasty: report of a large cohort and systematic review

Abstract

Purpose To evaluate retrospectively safety and effectiveness of cervical vertebroplasty (cVP) based on a single centre large cohort. Materials and Methods All cVP performed at single centre from January 2001 to October 2014 were included and reviewed. Procedure-related complications (minor and major) were systematically recorded. Effectiveness in terms of analgesia was evaluated using a semi-quantitative grading scale at one-month follow-up. Risk factors for the occurrence of a procedure-related complication or cement leakage, as well as factors influencing pain relief at one-month follow-up were evaluated using a multivariate analysis. Results One hundred and forty cVP procedures (176 vertebrae) were performed in 130 consecutive patients (88 female, 42 male; mean age = 56y) during the inclusion period. Among the treated lesions, 80% were bone metastases (mostly from breast cancer), 8% were related to haematological malignancies and 12% were nonmalignant lesions. One fatal complication (0.7%) was related to cement migration in the vertebrobasilar system. Three cervical hematomas were recorded, one of them requiring prolonged oral intubation. Overall rate of major complications was 1.5%. At one month, pain reduction was observed in 76% of the cases. Additional surgical fixation was required in 6.1% of the cases. cVP of more than one vertebra during the same session was an independent risk factor for procedure-related complication. Conclusion Cervical vertebroplasty is a safe technique with an acceptable major complication rate. Its effectiveness in terms of pain relief is good at mid-term follow-up.

CT-Guided Percutaneous Vertebroplasty of the Cervico-Thoracic Junction for the Management of Pathologic Fracture or Symptomatic Lytic Lesion in Cancer Patients

“…Mean procedure duration was 57 ± 22 min (range [31-142]). A total of 14 vertebrae (mean 1.3 vertebrae per patient, range [1,2]) were treated (Table 1). Twelve vertebrae (86%) were accessed via a unilateral and two (14%) via a bilateral approach.…”

“…In addition to radiation therapy, surgery, and medical treatment, percutaneous vertebroplasty (PV) is now commonly applied to treat pathologic fractures at the cervical and or thoracic levels [1,2]. At the cervicothoracic junction (vertebrae C7, T1, T2, and T3), due to interference from the shoulders, conventional PV with fluoroscopic guidance can be challenging and even impossible [3].…”

“…Technical success was achieved in 14/14 (100%) of vertebrae. Mean postoperative hospitalization duration was 1.9 ± 1.7 days (range [1][2][3][4][5][6][7][8][9][10][11]). According to CIRSE classification, no adverse event occurred.…”

Transoral vertebroplasty for the C1 lateral mass

“…5 Five patients of the present study have also been already reported through a study presenting the authors' experience in cervical vertebroplasty (from C1 to C7), reporting the safety and effectiveness of 140 cervical vertebroplasty procedures. 7…”

Combined Percutaneous Kyphoplasty/Pediculoplasty by Posterolateral Transpedicular Approach for Painful Cervical Spine Metastases: A Single-Center Prospective Study

“…Lesions of the cervical spine account for 8–15% of all spinal metastases 1 , 2 causing intractable pain or numbness and markedly undermining quality of life. Percutaneous vertebral augmentation (PVA), including percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP), is a minimally invasive and promising technique for treating painful cervical spine metastases (PCSMs) 3–6 cited in international guidelines. 7–9 Percutaneous pediculoplasty (PPP), as a non-classical PVA technique, has been applied to patients with vertebral pedicle involvement.…”