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Percutaneous vertebroplasty of the cervical spine performed via a posterior trans-pedicular approach

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Percutaneous vertebroplasty (PV) of the cervical spine has been traditionally performed with a trans-oral or antero-lateral approach. The posterior trans-pedicular approach (PTPA) has been sporadically reported. Therefore, the aim of this study is to retrospectively assess the technical feasibility, safety, and clinical outcomes of cervical PV performed with a PTPA.

Methods

All consecutive patients undergoing PV in cervical levels with PTPA (under general anesthesia and computed tomography [CT] guidance) from January 2008 to November 2019 were identified. The following data were collected: patients’ demographics; indication for PV; vertebral level features; procedure-related variables; and clinical outcomes including complications and pain relief.

Results

Thirty-two patients (18 females, 14 males; mean age 61.1 ± 13.2 years, range 36–88) were included accounting for 36 vertebrae. Three vertebrae (3/36, 8%) were referred due to an underlying traumatic fracture, the remaining (33/36, 92%) due to a painful lytic tumor. Technical success was 97% (35/36 levels). Mean time required to deploy the trocar was 23 ± 11 min (range 7–60). Extra-vertebral asymptomatic cement leakage was observed in 3/35 (9%) vertebral levels. One patient (1/32, 3%) developed an acute cardiogenic pulmonary edema requiring admission in the intensive care unit; another patient (1/32, 3%) developed localized infection to the skin entry site, which was managed conservatively. At 1-month follow-up, the mean pain in the study population was 1.0 ± 1.1 (range 0–4/10) vs 6.2 ± 1.4 (range 4–9/10) at baseline (p < 0.05).

Conclusions

Cervical PV performed via a CT-guided PTPA is technically feasible, safe, and results in effective pain relief.

Key Points

• Percutaneous vertebroplasty (PV) is a well-established technique for the treatment of benign and malignant compression fractures.

• Common PV approaches used for cervical vertebrae include the trans-oral, antero-lateral, lateral, and sporadically the posterior trans-pedicular approach.

• Retrospective analysis of our 11-year experience with the posterior trans-pedicular approach used for cervical vertebrae proved that such approach was safe and effective.

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Abbreviations

ALA:

Antero-lateral approach

BMI:

Body mass index

DLP:

Dose length product

IQRs:

Interquartile ranges

LA:

Lateral approach

PTPA:

Posterior trans-pedicular approach

PV:

Percutaneous vertebroplasty

TOA:

Trans-oral approach

References

  1. Health Quality Ontario (2016) Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ont Health Technol Assess Ser 16(11):1–202

    PubMed Central  Google Scholar 

  2. Tsoumakidou G, Too CW, Koch G et al (2017) CIRSE guidelines on percutaneous vertebral augmentation. Cardiovasc Intervent Radiol 40(3):331–342

    Article  Google Scholar 

  3. Anselmetti GC, Marcia S, Saba L et al (2012) Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol 81(12):4083–4086

    Article  Google Scholar 

  4. Clarençon F, Fahed R, Cormier E et al (2020) Safety and effectiveness of cervical vertebroplasty: report of a large cohort and systematic review. Eur Radiol 30(3):1571–1583

    Article  Google Scholar 

  5. Tong FC, Cloft HJ, Joseph GJ, Rodts GR, Dion JE (2000) Transoral approach to cervical vertebroplasty for multiple myeloma. AJR Am J Roentgenol 175(5):1322–1324

  6. Guo WH, Meng MB, You X et al (2012) CT-guided percutaneous vertebroplasty of the upper cervical spine via a translateral approach. Pain Physician 15(5):E733–E741

    PubMed  Google Scholar 

  7. Sun HY, Lee JW, Kim KJ, Yeom JS, Kang HS (2009) Percutaneous intervention of the C2 vertebral body using a CT-guided posterolateral approach. AJR Am J Roentgenol 193(6):1703–1705

  8. Cianfoni A, Distefano D, Chin SH, Varma AK, Rumboldt Z, Bonaldi G (2012) Percutaneous cement augmentation of a lytic lesion of C1 via posterolateral approach under CT guidance. Spine J 12(6):500–506

  9. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL (2017) Cirse quality assurance document and standards for classification of complications: the CIRSE classification system. Cardiovasc Intervent Radiol 40(8):1141–1146

  10. De la Garza-Ramos R, Benvenutti-Regato M, Caro-Osorio E (2016) Vertebroplasty and kyphoplasty for cervical spine metastases: a systematic review and meta-analysis. Int J Spine Surg 10:7

    Article  Google Scholar 

  11. Bousson V, Guinebert S, Odri G et al (2020) Curved discography needle for percutaneous cervical spine vertebroplasty: a technical note. J Vasc Interv Radiol 31(4):686–689

    Article  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Service d’Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, BP 426, 67091, Strasbourg Cedex, France

    Roberto Luigi Cazzato, Pierre de Marini, Pierre Auloge, Pierre Alexis Autreausseau, Guillaume Koch, Julien Garnon & Afshin Gangi

  2. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd, Oxford, OX3 7LD, UK

    Danoob Dalili

  3. School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK

    Danoob Dalili

  4. Service de Radiologie, Hôpitaux Civils de Colmar, Colmar, 39 Avenue de la Liberté, 68024, Colmar, France

    Pramod Rao

Authors
  1. Roberto Luigi Cazzato
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  2. Pierre de Marini
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  3. Pierre Auloge
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  4. Pierre Alexis Autreausseau
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  5. Guillaume Koch
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  6. Danoob Dalili
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  7. Pramod Rao
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  8. Julien Garnon
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  9. Afshin Gangi
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Corresponding author

Correspondence to Roberto Luigi Cazzato.

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Guarantor

The scientific guarantor of this publication is Pr Afshin Gangi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Cite this article

Cazzato, R.L., de Marini, P., Auloge, P. et al. Percutaneous vertebroplasty of the cervical spine performed via a posterior trans-pedicular approach. Eur Radiol 31, 591–598 (2021). https://doi.org/10.1007/s00330-020-07198-6

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  • DOI: https://doi.org/10.1007/s00330-020-07198-6

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