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Percutaneous Vertebroplasty Relieves Pain in Metastatic Cervical Fractures

  • Symposium: Current Concepts in Cervical Spine Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Percutaneous vertebroplasty is currently an alternative for treating vertebral fractures of the thoracic and lumbar spine, providing both pain control and vertebral stabilization. In the cervical spine, however, percutaneous vertebroplasty is technically challenging because of the complex anatomy of this region.

Questions/purposes

We evaluated the technical feasibility, complication rate, and ability of percutaneous vertebroplasty to provide pain relief in patients with painful metastatic cervical fractures.

Methods

We retrospectively reviewed 62 patients (24 men) who, between May 2005 and May 2009, underwent vertebroplasty to treat painful metastatic cervical fractures. Each patient was evaluated by a visual analog scale for pain, number of pain analgesics, and CT and MRI before, the day after, and at 3 months after the procedure.

Results

Two of the 62 patients had asymptomatic cement leakage in the soft tissues. We observed no delayed complications. Mean pretreatment and 24-hour posttreatment visual analog scale pain scores were 7.9 ± 1.7 and 1.5 ± 2, respectively. Immediately after surgery, the pain completely disappeared in 25 (40%) patients. Administration of analgesics was suspended in 34 (55%) patients whereas in 27 (39%) patients the median analgesics use decreased from two pills per day (range, 0–3) to 0 (range, 0–3). In two (3%) patients, analgesics administration was continued due to the persistence of pain. At 3 months, the patients reported a mean visual analog scale pain score of 1.7 ± 2.

Conclusions

Our data suggest, in selected patients, percutaneous vertebroplasty may be performed with a high technical success rate combined with a low complication rate, providing immediate pain relief lasting at least 3 months and a reduction in the use of analgesic drugs.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy

    S. Masala MD, M. Mammucari MD, T. Volpi MD & G. Simonetti MD

  2. Institute for Cancer Research and Treatment, Candiolo, Turin, Italy

    G. C. Anselmetti MD

  3. Department of Neuroradiology, Cardarelli Hospital, Naples, Italy

    M. Muto MD

Authors
  1. S. Masala MD
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  2. G. C. Anselmetti MD
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  3. M. Muto MD
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  4. M. Mammucari MD
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  5. T. Volpi MD
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  6. G. Simonetti MD
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Corresponding author

Correspondence to S. Masala MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

The work was performed at University of Rome “Tor Vergata”, at the Institute for Cancer Research and Treatment, and at Cardarelli Hospital.

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Masala, S., Anselmetti, G.C., Muto, M. et al. Percutaneous Vertebroplasty Relieves Pain in Metastatic Cervical Fractures. Clin Orthop Relat Res 469, 715–722 (2011). https://doi.org/10.1007/s11999-010-1550-y

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  • DOI: https://doi.org/10.1007/s11999-010-1550-y

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