title: Minimally invasive combined anterior kyphoplasty for osteolytic C2 and C5 metastases.
abstract: Kypho- and vertebroplasty are widely accepted for treating patients suffering from pathologic thoracolumbar lesions, in particular diffuse metastatic-induced fractures. They provide rapid pain relief and the restoration of spinal stability. In the cervical spine, attempts have been made to use cement augmentation for these indications. However, the cervical spine's anatomy complicates the transpedicular approach, as well as the pre-formation of a vertebral body cavity and the application of bone cement. We report the case of a 46-year-old woman suffering from symptomatic C2 and C5 osteolysis caused by metastatic breast cancer. Following a surgical staging and classification (Tokuhashi-Score) that indicated palliative procedures, we performed a C2 and C5 kyphoplasty using one minimal-invasive anterior approach through a small incision. We observed an uneventful procedure and postoperative course as well as immediate pain relief and patient mobilization. Last patient follow-up at 3 months showed an excellent outcome. Our observations showed cervical spine kyphoplasty via a minimally invasive anterior approach to be feasible, successful and safe surgical method in the interdisciplinary palliative treatment.
authors.affiliation: Musculoskeletal Tumour Surgery Section, Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Druschel
authors.forename: K D
authors.initials: KD
authors.lastname: Schaser
authors.forename: I
authors.initials: I
authors.lastname: Melcher
authors.forename: N P
authors.initials: NP
authors.lastname: Haas
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Disch
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010147:Pain Measurement; D010166:Palliative Care; D011788:Quality of Life; D011859:Radiography; D018570:Risk Assessment; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome