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Safety and effectiveness of cervical vertebroplasty: report of a large cohort and systematic review

  • Frédéric ClarençonEmail author
  • Robert Fahed
  • Evelyne Cormier
  • Idriss Haffaf
  • Jean-Philippe Spano
  • Eimad Shotar
  • Kévin Premat
  • Raphael Bonaccorsi
  • Vincent Degos
  • Jacques Chiras
Interventional
  • 38 Downloads

Abstract

Purpose

To evaluate retrospectively safety and effectiveness of cervical vertebroplasty (cVP) based on a single-center large cohort.

Materials and methods

All cVP performed at a single center from January 2001 to October 2014 were included and reviewed. Procedure-related complications (minor and major) were systematically recorded. Effectiveness in terms of analgesia was evaluated using a semi-quantitative grading scale at 1-month follow-up. Risk factors for the occurrence of a procedure-related complication or cement leakage, as well as factors influencing pain relief at 1-month follow-up, were evaluated using a multivariate analysis.

Results

One hundred and forty cVP procedures (176 vertebrae) were performed in 130 consecutive patients (88 female, 42 male; mean age = 56 years) during the inclusion period. Among the treated lesions, 80% were bone metastases (mostly from breast cancer), 8% were related to hematological malignancies, and 12% were non-malignant lesions. One fatal complication (0.7%) was related to cement migration in the vertebrobasilar system. Three cervical hematomas were recorded, one of them requiring prolonged oral intubation. The overall rate of major complications was 1.5%. At 1 month, pain reduction was observed in 76% of the cases. Additional surgical fixation was required in 6.1% of the cases. cVP of more than one vertebra during the same session was an independent risk factor for procedure-related complications.

Conclusion

Cervical vertebroplasty is a safe technique with an acceptable major complication rate. Its effectiveness in terms of pain relief is good at mid-term follow-up.

Key Points

Cervical vertebroplasty (cVP) is a safe procedure with a low rate of major complications (1.5%).

cVP provides pain relief in 76% of the cases.

Additional fixation surgery is rarely required after cVP (6.1% of the cases).

Keywords

Vertebroplasty Spine Analgesia 

Abbreviations

ABC

Aneurysmal bone cyst

cVP

Cervical vertebroplasty

IV

Intravenous

PMMA

Polymethyl methacrylate

PVP

Percutaneous vertebroplasty

VA

Vertebral artery

VP

Vertebroplasty

Notes

Funding information

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Pr Frédéric Clarençon.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise (Pr F. Clarençon).

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was not required because retrospective analysis of a patients’ charts and imaging data is not required by our local IRB.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in:

Mont’Alverne F, Vallee JN, Cormier E, et al Percutaneous vertebroplasty for metastatic involvement of the axis. AJNR Am J Neuroradiol 2005;26:1641-1645

Mont’Alverne F, Vallee JN, Guillevin R, et al Percutaneous vertebroplasty for multiple myeloma of the cervical spine. Neuroradiology 2009;51:237-242

Clarencon F, Cormier E, Pascal-Moussellard H, et al Transoral approach for percutaneous vertebroplasty in the treatment of osteolytic tumor lesions of the lateral mass of the atlas: feasibility and initial experience in 2 patients. Spine (Phila Pa 1976) 2013;38:E193-197

Pham CT, Clarencon F, Ganem G, et al Spinal cervical metastasis from a glioblastoma multiform treated by percutaneous vertebroplasty: a case report. J Neuroradiol 2011;38:323-325.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Frédéric Clarençon
    • 1
    • 2
    Email author
  • Robert Fahed
    • 3
  • Evelyne Cormier
    • 1
  • Idriss Haffaf
    • 1
  • Jean-Philippe Spano
    • 2
    • 4
  • Eimad Shotar
    • 1
    • 2
  • Kévin Premat
    • 1
    • 2
  • Raphael Bonaccorsi
    • 5
  • Vincent Degos
    • 2
    • 6
  • Jacques Chiras
    • 1
    • 2
  1. 1.Sorbonne UniversityParisFrance
  2. 2.Department of NeuroradiologyPitié-Salpêtrière Hospital, APHPParisFrance
  3. 3.Department of Interventional NeuroradiologyFondation A. de RothschildParisFrance
  4. 4.Department of OncologyPitié-Salpêtrière HospitalParisFrance
  5. 5.Department of Orthopedic SurgeryPitié-Salpêtrière HospitalParisFrance
  6. 6.Department of AnesthesiologyPitié-Salpêtrière HospitalParisFrance

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