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

ABSTRACT

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 preoperatively as baseline and at 24 hours and 1, 6, and 12 months postoperatively, until death, or until loss to follow-up. The Oswestry Disability Index was used to evaluate the patients' functional disability preoperatively. 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) preoperatively to 1.6 (SD ± 1.5) 24 hours postoperatively, 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.