Percutaneous Vertebroplasty For Metastatic Lesions Of The Cervical Spine

Objective: Due to the difference of the location and surrounding structuresof each cervical vertebral body, the optimal choice of the operative approachof percutaneous vertebroplasty (PVP) should be individualized. To evaluationthe safety， effectiveness of the three approaches of percutaneousvertebroplasty for metastatic lytic lesions of the cervical spine.Methods:40patients with osteolytic cervical metastases in65cervicalvertebras received the treatment of the PVP. The clinical data wereretrospectively analyzed. The WHO standards and Visual analogue scale(VAS) were assessed before and after operation, and the three operativeapproaches were analyzed and summarized according to the differentpositions of the cervical body.Results: The three groups of puncture path are respectively anterolateralapproach, lateral approach, and anterolateral approach through disc space. Allthe cervical bodies were successfully punctured and injected with bonecement. Follow-up at least3months,13cases of complete remission (CR),21cases of part remission (PR),2case of mild remission (MR),0is no remission(NR) after operation in data integrity of the36patients, while the rate of theclinical effective (CR+PR) reaching94.44%. Preoperative and postoperative patients with24h, after one week,3months after operation, the VASdifferences were statistically significant (P<0.05). A little bone cementleakage occurred in17vertebral bodies（26.15%）, but without any seriousclinical complications.Conclusion: Percutaneous vertebroplasty via anterolateral approach is asafe, effective technique in treating the osteolytic metastasis tumor of lowercervical vertebra (C4～C7). While treating metastasis tumor involved in C1、C2and C3，it’s safe and feasible to choose percutaneous vertebroplasty vialateral approach and anterolateral approach through disc space. The optimalchoice of the operative approach should be individualized, and specificcircumstances should be taken into consideration.