The role of vertebroplasty in metastatic spinal disease

Pilitsis, Julie G.; Rengachary, Setti S.

doi:10.3171/foc.2001.11.6.10

Cited by 51 publications

(35 citation statements)

References 25 publications

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“…It has been proven to result in rapid pain relief with a low rate of clinical complications [13,18]. Reported complications of PV in the treatment of spinal metastases are more common than that in osteoporotic compression fractures [10,24,27]. In this report, the authors document a rare complication of extradural arachnoid cyst following PV in a patient with spinal metastasis.…”

Section: Introductionmentioning

confidence: 79%

Spinal extradural arachnoid cyst following percutaneous vertebroplasty

Mao¹,

Yang²,

Geng³

et al. 2010

Eur Spine J

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We report a rare complication of extradural arachnoid cyst following percutaneous vertebroplasty in a spinal metastasis patient. Percutaneous vertebroplasty has been established as a safe and effective treatment for osteoporotic vertebral fractures and vertebral metastatic lesions. To our knowledge, extradural arachnoid cyst following vertebroplasty has not been reported in literature. A 48-year-old woman diagnosed with adenocarcinoma underwent percutaneous vertebroplasty at the L3 vertebral level due to painful solitary spinal metastasis. At 5 months after surgery, the patient complained of low back pain radiating to the left lower extremity. MRI showed a large cystic lesion in the spinal canal at the L2-L3 level with compression to adjacent dura sac. On T1-and T2-weighted images, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent laminectomy for excision of the extradural cyst. Intraoperatively, a small communication between the cyst and the subarachnoid space was seen at the level of the L3 pedicle. Pathological examination revealed that the cyst wall was composed of non-specific fibrous connective tissue and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the patient's symptom was relieved immediately. The iatrogenic dural injury produced by puncture of the pedicle during vertebroplasty may be the cause of formation of the extradural arachnoid cyst.

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Section: Introductionmentioning

confidence: 79%

Spinal extradural arachnoid cyst following percutaneous vertebroplasty

Mao¹,

Yang²,

Geng³

et al. 2010

Eur Spine J

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“…Furthermore, PMMA could have an antitumor activity as a result of cytotoxicity, thermal effects, and ischemia. 89 The indication for this procedure is painful vertebral metastasis without neurologic compromise. Contraindications are compression of neurologic structures, significant coagulopathy, infection, known allergic reactions against PMMA, pregnancy, poor general condition, or short expected life expectancy.…”

Section: Vertebroplasty/kyphoplastymentioning

confidence: 99%

“…Contraindications are compression of neurologic structures, significant coagulopathy, infection, known allergic reactions against PMMA, pregnancy, poor general condition, or short expected life expectancy. [89][90][91] The major advantage of these procedures compared with radiotherapy alone is the immediate positive contribution to spinal stability. 89,[91][92][93] The rate of symptomatic complication following vertebroplasty is approximately 10%.…”

Section: Vertebroplasty/kyphoplastymentioning

confidence: 99%

Spinal Extradural Metastasis: Review of Current Treatment Options

Bartels

Linden

Graaf

2008

CA: A Cancer Journal for Clinicians

198

145

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Bone metastases, especially to the spine, are frequently encountered during the course of a malignancy. Due to a worldwide increase of cancer incidence and to a longer life expectancy of patients with cancer, a rise in incidence of bone metastases is observed. A brief historical overview is the base of a review of current treatment options. Despite new developments in the surgical and radiotherapeutic fields, as well as in medical oncology, external beam radiotherapy is the cornerstone of the treatment of spinal metastases. In selected cases, surgical treatment is a proven option. Vertebroplasty or kyphoplasty can also be considered.Supportive medical care does not differ from that given for symptomatic lesions to the skeletal system elsewhere in the body. After discussing the treatment options, an algorithm is given. (CA Cancer J Clin 2008;58:245-259.)

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“…13 Complications, including epidural cement leak causing neuralgia, rib and pedicle fractures, cement pulmonary embolism, and foraminal venous leak into intercostal arteries are described in various reports of vertebroplasty. 2,[21][22][23] There are not many published reports of C-2 vertebro-R. Rhiew et al…”

Section: Discussionmentioning

confidence: 99%

“…The injection of radiopaque cement across a cervical spine fracture increases the strength and stiffness of the VB and has been shown to provide pain control in up to 90% of patients. 20,21,23,30 Both anterolateral and transoral approaches have been successfully implemented for the treatment of metastatic lesions in the upper cervical spine. 8,15,16,28,29 While efficacious, both approaches carry potentially life-threatening complications.…”

mentioning

confidence: 99%

Minimally invasive anterior vertebroplasty for C-2 metastatic lesions

Rhiew¹,

Manjila²,

DeZure³

et al. 2008

FOC

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The authors describe a technique for minimally invasive anterior vertebroplasty for treating metastatic disease of the C-2 vertebra and discuss its application in 2 cases. After a 2-cm lateral neck incision is made, blunt dissection is performed toward the anterior inferior endplate of the C-2 vertebra. An 11-gauge needle is introduced through a tubular sheath and tapped into the inferior endplate of C-2, with biplanar fluoroscopy being performed to confirm position. The needle is subsequently advanced across the fracture line and into the odontoid process. Under fluoroscopic guidance, 2 ml of methylmethacrylate is injected into the odontoid process and vertebral body. This method is advantageous as 1) hyperextension of the neck is not performed, 2) the chance of inadvertent neurovascular or submandibular gland injury is minimized, 3) the possibility of cement leakage is decreased, and 4) hemostasis is better achieved under direct vision.

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The role of vertebroplasty in metastatic spinal disease

Cited by 51 publications

References 25 publications

Spinal extradural arachnoid cyst following percutaneous vertebroplasty

Spinal extradural arachnoid cyst following percutaneous vertebroplasty

Spinal Extradural Metastasis: Review of Current Treatment Options

Minimally invasive anterior vertebroplasty for C-2 metastatic lesions

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