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

Eur Radiol. 2020 Mar;30(3):1571-1583. doi: 10.1007/s00330-019-06525-w. Epub 2019 Nov 20.

Abstract

Purpose: To evaluate retrospectively safety and effectiveness of cervical vertebroplasty (cVP) based on a single-center large cohort.

Materials and methods: All cVP performed at a single center 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 1-month follow-up. Risk factors for the occurrence of a procedure-related complication or cement leakage, as well as factors influencing pain relief at 1-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 = 56 years) during the inclusion period. Among the treated lesions, 80% were bone metastases (mostly from breast cancer), 8% were related to hematological malignancies, and 12% were non-malignant 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. The overall rate of major complications was 1.5%. At 1 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 complications.

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.

Key points: • Cervical vertebroplasty (cVP) is a safe procedure with a low rate of major complications (1.5%). • cVP provides pain relief in 76% of the cases. • Additional fixation surgery is rarely required after cVP (6.1% of the cases).

Keywords: Analgesia; Spine; Vertebroplasty.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Cements*
  • Cervical Vertebrae* / diagnostic imaging
  • Cervical Vertebrae* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neck Pain* / diagnosis
  • Neck Pain* / surgery
  • Pain Management
  • Pain Measurement
  • Radiography
  • Retrospective Studies
  • Systematic Reviews as Topic*
  • Treatment Outcome
  • Vertebroplasty* / methods
  • Young Adult

Substances

  • Bone Cements