Cervical vertebroplasty for osteolytic metastases as a minimally invasive therapeutic option in oncological surgery: outcome in 14 cases

Authors Stangenberg M, Viezens L, Eicker SO, Mohme M, Mende KC, Dreimann M.
Institute Dept of Trauma, Hand and Reconstructive Surgery and Neurosurgery University Hospital Hamburg-Eppendorf, Hamburg Dept of Trauma Surgery, Orthopedics and Plastic Surgery          University Hospital Goettingen, Germany 
Journal Neurosurg Focus. 2017 Aug;43(2):E3.
Take Home message
High viscosity resin can reduce the risk of leakage in cervical fracturesVertebroplasty can reduce pain and restore stability in patients with osteolytic spinal metastases
Summary
14 patients with osteolytic metastases of cervical spine underwent vertebroplasty alone or combined with another surgery in a palliative setting to reduce pain and restore stability
Sample characteristics
14 patients (8M, 6F); mean age of 65 years (44 – 85); 25 vertebrae Aetiology: metastatic disease of the cervical spine due to myeloma (10), breast carcinoma (2), pulmonary cancer (1), unknown origin (1)
Mean FU (range)
9M (2 – 20) for 12 pts
Vertebral filling
Radiologically, good cement distribution and filling of the resection cavity was demonstrated in all cases
Complications
Leakage: 14% (2/14) – asymptomaticNeurological examination unchangedNo surgery-related complications
Key points
– anterior vertebroplasty of cervical spine is a secure, minimally invasive procedure with a low complication rate for osteolytic metastases 
– effective for reducing pain and restoring stability, can be combined with other ventral or dorsal procedures of cervical spine, and, in the axis vertebra, can be performed from posteriorly. 
– the posterior wall of the vertebral body should be intact to avoid potentially dangerous complications such as intraspinal leakage with a risk of high para- or tetraparesis
– to prevent cement leakage and embolization, cement should have an adequate consistency, a high-resolution fluoroscopic device should be used, the injection should be stopped immediately if leakage is recognized

Source: TECRES – bone cement and preformed spacers

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