Percutaneous vertebroplasty relieves pain in metastatic cervical fractures.
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.


OBJECTIVE
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.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Masala
S
S
Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. salva.masala@tiscali.it
Anselmetti
G C
GC
Muto
M
M
Mammucari
M
M
Volpi
T
T
Simonetti
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*