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

• Published in: European radiology Vol. 30; no. 3; pp. 1571 - 1583
• Main Authors: Clarençon, Frédéric, Fahed, Robert, Cormier, Evelyne, Haffaf, Idriss, Spano, Jean-Philippe, Shotar, Eimad, Premat, Kévin, Bonaccorsi, Raphael, Degos, Vincent, Chiras, Jacques
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2020; Springer Nature B.V; Springer Verlag
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analgesia; Bone Cements; Bone surgery; Breast cancer; Cement; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Cervix; Chemical Sciences; Complications; Diagnostic Radiology; Evaluation; Female; Fixation; Follow-Up Studies; Hematology; Hematoma; Humans; Imaging; Internal Medicine; Interventional; Interventional Radiology; Intubation; Lesions; Life Sciences; Male; Medicine; Medicine & Public Health; Metastases; Middle Aged; Multivariate analysis; Neck Pain - diagnosis; Neck Pain - surgery; Neuroradiology; Pain; Pain Management; Pain Measurement; Pain perception; Radiochemistry; Radiography; Radiology; Retrospective Studies; Risk analysis; Risk factors; Safety; Surgery; Systematic Reviews as Topic; Treatment Outcome; Ultrasound; Vertebrae; Vertebroplasty - methods; Young Adult; Analgesia; Spine; Vertebroplasty; spine; analgesia
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-019-06525-w

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).