Feasibility and Safety of Lateral and Posterolateral Percutaneous Vertebroplasty of Osteolytic C1-C2 Lesions under Computed Tomography Guidance and Local Anesthesia.

PURPOSE: To evaluate the safety and effectiveness of lateral or posterolateral percutaneous vertebroplasty (PVP) of osteolytic C1-C2 lesions performed under computed tomography (CT) guidance and local anesthesia.

MATERIALS AND

METHODS

A retrospective study of 16 consecutive patients (11 females and 5 males; aged from 24 to 86 years; median age, 65.5 years) who underwent 17 lateral or posterolateral PVP was performed. Pain status was assessed using a visual analog scale (VAS). Patients were evaluated preprocedurally as baseline and at 24 hours and 1, 6, and 12 months postprocedurally, until death, or until loss to follow-up. The Oswestry Disability Index was used to evaluate the patients' functional disability preprocedurally. The adverse events were recorded using the Society of Interventional Radiology (SIR) classification.

RESULTS

The technical success was 100% (17/17) for a median Spinal Instability Neoplastic Score of 13.5 (interquartile range [IQR], 6.8, 20.3). Mean clinical follow-up was 10.1 months (range, 6-36 months; median, 19.5 months, IQR, 4, 35 months). Mean VAS score decreased significantly from 7.5 (SD ± 2.1) preprocedurally to 1.6 (SD ± 1.5) 24 hours postprocedurally, and 1.0 (SD ± 1.1), 1.5 (SD ± 1.0), and 0.5 (SD ± 1.5) at 1, 6, and 12 months, respectively (all P < .001). No severe adverse events were observed, but 3 cases of asymptomatic cement leakage were noted (SIR Grade 1; 17.6% [3/17]).

CONCLUSIONS

Lateral and posterolateral PVP performed under CT guidance and local anesthesia is safe and effective to treat symptomatic osteolytic C1-C2 lesions.