Transoral vertebroplasty of the lateral mass of C1 using image guidance

Kavakebi, Pujan; Girod, Pierre Pascal; Hartmann, Sébastian; Tschugg, Anja; Thomé, Claudius

doi:10.1007/s00701-017-3158-4

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…C1 vertebroplasty via the transoral approach is the most commonly reported method in literature. 5 , 6 , 8 , 18 It is the most direct route from C1, and the direction of needle entry is safe for the vertebral artery, unless there are some patients with congenital variation of blood vessels. 19 However, the needle path has a medial to lateral direction, which is often not along the long axis of the lesion.…”

Section: Discussionmentioning

confidence: 99%

“…The puncture approaches mainly include transoral, lateral, posterolateral, and anterior retropharyngeal approaches. [5][6][7][8][9][10][11][12][13][14] Among them, only transoral PVP has been proven to be a relatively safe procedure, but it is not suitable for all patients.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, only 29 atlas vertebrae have been reported across all existing publications, and 22 of them were treated using PVP by transoral approach. 5,6,8,9,14 Other puncture routes are rarely mentioned, and most of them are in the form of case reports. 7,[10][11][12][13] They used different puncture methods, and all studies used auxiliary means such as preventive vertebral artery occlusion and CT-guided puncture positioning.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Yang

Tian

Wang

et al. 2021

JPR

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Objective: To report our experience of treating painful C1 osteolytic lesions with cement augmentation via a lateral approach under fluoroscopic guidance. Materials and Methods: Nine consecutive patients (eight men and one woman; mean age: 56.7±13.2 years) with osteolytic lesions of the atlas who underwent cementoplasty via a lateral approach were enrolled in this study. The technical success rate, operation time, and complications were recorded. Visual analogue scale (VAS) and Neck disability index (NDI) were used to evaluate the pain relief and neck function status pre-procedure (baseline) and post-procedure (at 3 days; after 1, 3, 6, 12, 18, and 24 months; and at the last follow-up). Results: The procedure was technically successful without any complications in all patients. The mean procedure time was 44.3±7.8 min. There were three cases of bone cement leakage, but no clinical symptoms. The mean VAS score decreased from 6.7±1.0 before the procedure to 3.7 three days after the procedure. The mean NDI score decreased from 67.3±11.2 before the procedure to 39.3±13.7 three days after the procedure. The VAS and NDI scores decreased at each follow-up time point, and the difference was statistically significant compared with the scores before the procedure (P<0.01). Conclusion: Fluoroscopy-guided lateral approach is a feasible, safe, and effective method for treatment of osteolytic lesions of the atlas and can relieve pain and stabilize the bone.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Yang

Tian

Wang

et al. 2021

JPR

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“…The anterolateral approach for POP, under the guidance of both ultrasound and fluoroscope, is safe under local anesthesia. The transoral approach has also been introduced; however, it can be performed under general anesthesia with nasotracheal intubation [ 18 ].…”

Section: Main Bodymentioning

confidence: 99%

Percutaneous osteoplasty for painful bony lesions: a technical survey

Kim

2021

Korean J Pain

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Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

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Transoral vertebroplasty for the C1 lateral mass

Clarençon

Shotar

Cormier

et al. 2020

J NeuroIntervent Surg

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BackgroundOsteolytic lesions of the atlas (C1) are challenging to treat by vertebroplasty due to the vicinity of the vertebral artery and the spinal cord.ObjectiveTo present our experience with transoral vertebroplasty (TOV) for osteolytic lesions of the lateral mass of the atlas.MethodsRetrospective case series involving 15 consecutive patients (nine male, six female, mean age 63 years) who underwent TOV for the treatment of an osteolytic lesion of the lateral mass of the atlas. Among the osteolytic lesions, 10/15 (67%) were bone metastases from various cancers; 4/15 (27%) were lesions related to multiple myeloma; and one lesion (7%) was an aggressive hemangioma. All the TOVs were performed under general anesthesia and in most cases (10/15; 67%) in a hybrid angiosuite combining a C-arm flat panel and a CT scan. The remaining five patients were treated under biplane fluoroscopic guidance.ResultsVertebroplasty of the lateral mass of C1 through a transoral route was feasible in all cases. Significant pain relief was obtained in most cases (1 month average decrease in Numeric Rating Scale: 4.9±4.1). No major complication was recorded. In 7/15 cases (47%), cement leakage surrounding the C1 lateral mass was seen; none of these leakages had a significant clinical consequence. No additional spine surgery was required in any of the patients.ConclusionTOV of osteolytic lesions of the lateral mass of the atlas is feasible and seems safe and effective, providing pain relief and bone stabilization.

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Transoral vertebroplasty of the lateral mass of C1 using image guidance

Cited by 3 publications

References 8 publications

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Percutaneous osteoplasty for painful bony lesions: a technical survey

Transoral vertebroplasty for the C1 lateral mass

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