CT-Guided Percutaneous Vertebroplasty of the Cervico-Thoracic Junction for the Management of Pathologic Fracture or Symptomatic Lytic Lesion in Cancer Patients

Cardiovasc Intervent Radiol. 2022 Feb;45(2):244-248. doi: 10.1007/s00270-021-03018-6. Epub 2021 Dec 1.

Abstract

Objectives: The purpose of this retrospective observational study is to report author's experience in computed-tomography (CT)-guided percutaneous vertebroplasty (PV) of the cervicothoracic junction.

Methods: The records of all consecutive patients treated by PV at levels C7, T1, T2, and T3 in a tertiary cancer center during year 2020 were extracted from the Institutional electronic archive. Following data were collected: demographics, indication for PV, procedure features, outcomes, and complications. Technical success was defined as when the trocar was placed into the vertebral body, allowing the injection of polymethyl-metacrylate (PMMA).

Results: Eleven patients were identified who received PV on 14 levels. Mean procedure duration was 57 ± 22 min (range [31-142]). A "trans-pedicular approach at the targeted level" was used in 1 vertebra (7%), a "costotransverse approach, at the targeted level" was used in 1 vertebra (7%), a "transpedicular approach via the level below" was used in 3 vertebrae (22%), and a "costotransverse approach via the level below" was used in 9 vertebrae (64%). Meantime to deploy each trocar was 20 ± 5 min (range [12-32]). Technical success was achieved in 14/14 (100%) of vertebrae. Mean postoperative hospitalization duration was 1.9 ± 1.7 days (range [1-11]). According to CIRSE classification, no adverse event occurred. PMMA leakage occurred in two patients; both remained asymptomatic.

Conclusion: This study provides arguments in favor of safety and efficiency of CT-guided vertebroplasty of levels C7, T1, T2, and T3, for both trocar deployment and monitoring of the vertebral body filling during the PMMA injection.

Keywords: Cementoplasty; Fractures; Interventional radiology; Pain management; Spinal neoplasms.

Publication types

  • Observational Study

MeSH terms

  • Bone Cements / therapeutic use
  • Fractures, Spontaneous*
  • Humans
  • Neoplasms*
  • Retrospective Studies
  • Spinal Fractures* / diagnostic imaging
  • Spinal Fractures* / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vertebroplasty*

Substances

  • Bone Cements