title: Percutaneous vertebroplasty at C2: case report of a patient with multiple myeloma and a literature review.
abstract: Percutaneous vertebroplasty (PVP) of the axis is a challenging procedure which may be performed by a percutaneous or a transoral approach. There are few reports of PVP at the C2 level. We report a case of unstable C2 fracture treated with the percutaneous approach. The fracture was the first manifestation of multiple myeloma in a previously healthy 47-year-old woman. After local radiotherapy and chemotherapy, the fracture was still unstable and the patient had been continuously wearing a stiff cervical collar for 9 months. Complication-free PVP resulted in pain relief and stabilization and use of the cervical collar could be discontinued. At 18 months follow-up the patient remained free from pain, the fracture was stable and she had returned to work. The purpose of this article is to present the technical facts and to highlight the benefits and potential complications of the procedure. The technical characteristics of the procedure, the indication and results of the present case are discussed together with previously reported cases of PVP treatment at C2.
authors.affiliation: Department of Diagnostic Radiology, Interventional Neuroradiology, Gothenburg, Sweden. miriam.rodriguez@vgregion.se
authors.forename: Miriam
authors.initials: M
authors.lastname: Rodriguez-Catarino
authors.forename: Cecilie
authors.initials: C
authors.lastname: Blimark
authors.forename: Jan
authors.initials: J
authors.lastname: Willén
authors.forename: Ulf-H
authors.initials: UH
authors.lastname: Mellqvist
authors.forename: Stig
authors.initials: S
authors.lastname: Rödjer
mesh_terms: D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001843:Bone Cements / Q000627:therapeutic use; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D019653:Myeloablative Agonists / Q000627:therapeutic use; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D011878:Radiotherapy; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation / Q000379:methods*
chemical_list: D001843:Bone Cements; D019653:Myeloablative Agonists; D008558:Melphalan