Minimally invasive anterior vertebroplasty for C-2 metastatic lesions.
The authors describe a technique for minimally invasive anterior vertebroplasty for treating metastatic disease of the C-2 vertebra and discuss its application in 2 cases. After a 2-cm lateral neck incision is made, blunt dissection is performed toward the anterior inferior endplate of the C-2 vertebra. An 11-gauge needle is introduced through a tubular sheath and tapped into the inferior endplate of C-2, with biplanar fluoroscopy being performed to confirm position. The needle is subsequently advanced across the fracture line and into the odontoid process. Under fluoroscopic guidance, 2 ml of methylmethacrylate is injected into the odontoid process and vertebral body. This method is advantageous as 1) hyperextension of the neck is not performed, 2) the chance of inadvertent neurovascular or submandibular gland injury is minimized, 3) the possibility of cement leakage is decreased, and 4) hemostasis is better achieved under direct vision.
Rhiew
Richard
R
Department of Neurological Surgery, Wayne State University, Detroit, Michigan 48201, USA.
Manjila
Sunil
S
Dezure
Adam
A
Tabbosha
Monir
M
Guthikonda
Murali
M
Eltahawy
Hazem
H
D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*