Transoral Approach for Percutaneous Vertebroplasty in the Treatment of Osteolytic Tumor Lesions of the Lateral Mass of the Atlas

Clarençon, Frédéric; Cormier, E.; Pascal‐Moussellard, Hugues; Pichon, S; Jean, Lise Le; Ikka, Léon; Chiras, J.

doi:10.1097/brs.0b013e31827d41c7

Cited by 8 publications

(13 citation statements)

References 16 publications

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“…There are a few reports of PVP in C1 and C2 spines as they are less affected; however, they are the most technical challenging anatomic regions. Posteroanterior [ 16 ], posterolateral [ 17 ], transoral [ 18 ], and anterior retropharyngeal approach [ 19 ] have been reported to perform PVP in C1 or C2. We have only one C2 patient and we successfully used anterolateral lateral approach.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Bao

Jia

et al. 2017

Pain Research and Management

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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.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Bao

Jia

et al. 2017

Pain Research and Management

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“…An anterolateral percutaneous approach to C2 and a transoral approach for vertebroplasty of C2 were described in 2002 [1, 5, 9]. The first publication of a vertebroplasty via a transoral access to C1 was published in 2013 [2]. The group showed a case series of patients presenting with osteolytic tumor lesion in C1.…”

Section: Discussionmentioning

confidence: 99%

Transoral vertebroplasty of the lateral mass of C1 using image guidance

et al. 2017

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BackgroundOsteolytic lesions of the anterior aspects of C1 (lateral mass) are difficult to address in a minimally invasive fashion and are often treated by craniocervical instrumentation.MethodsWe report the feasibility and technical method of transoral vertebroplasty of the lateral mass of the atlas using image guidance and describe the workflow of the procedure. To our knowledge, there has not yet been a technical description of a transoral vertebroplasty using image guidance.ResultsAdequate positioning of the pedicle access needle using image guidance for addressing the lateral mass of C1 through a transoral, permuceous access can be achieved.ConclusionsWith the assistance of image guidance, it is safe and feasible to access the lateral mass of the atlas. This constitutes a minimally invasive and fast alternative for introducing the bone needle to C1 rather than using a fluoroscopic device alone.

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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%

Minimally invasive resection and vertebroplasty for an osteolytic C-1 metastasis of malignant meningioma: case report

Klingler¹,

Krüger²,

Kogias³

et al. 2015

SPI

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Malignant meningiomas are a rare but aggressive subset of intracranial meningiomas leading to a very limited life expectancy. The occurrence of spinal metastases in these tumors is an even rarer event. The described patient had an intracranial malignant meningioma and developed a symptomatic osteolytic contrast-enhancing lesion in the left C-1 lateral mass suspicious for metastasis. The authors performed a minimally invasive posterior resection of the lesion with vertebroplasty of C-1. Histopathology verified metastasis of the malignant meningioma. The surgical procedure resulted in prompt and permanent pain reduction until the patient died 18 months later. Given the very limited life expectancy in this case, the authors did not consider occipitocervical fusion because of their desire to preserve the range of motion of the head. Therefore, they suggest minimally invasive tumor resection and vertebroplasty in selected palliative tumor patients.

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Transoral Approach for Percutaneous Vertebroplasty in the Treatment of Osteolytic Tumor Lesions of the Lateral Mass of the Atlas

Abstract: Transoral approach for the treatment of osteolytic tumor lesions of the lateral mass of the atlas is feasible and seems to be a safe and effective technique.

Cited by 8 publications

References 16 publications

Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Percutaneous Vertebroplasty Relieves Pain in Cervical Spine Metastases

Transoral vertebroplasty of the lateral mass of C1 using image guidance

Minimally invasive resection and vertebroplasty for an osteolytic C-1 metastasis of malignant meningioma: case report

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