APPLICATION OF ANTERIOR MINI-INCISION VERTEBROPLASTY IN CERVICAL METASTASES

APLICAÇÃO DE VERTEBROPLASTIA POR MINI-INCISÃO ANTERIOR EM METÁSTASES CERVICAIS

ABSTRACT

Objective  To investigate the efficacy and safety of anterior cervical mini-incision vertebroplasty in the treatment of vertebral metastases.

Methods  From July 2009 to March 2013, seven cases of vertebral metastases were treated by using vertebroplasty through an anterior cervical paratracheal mini-incision guided by C-arm X-ray in Beijing friendship hospital, Capital medical university. Among them, three were male and four were female, aged 51 to 74 years with an average age of 61.7 years. Preoperative and postoperative Visual Analog Scale (VAS) scores and analgesic medication usage were evaluated, and postoperative pain relief was assessed using the World Health Organization (WHO) criteria.

Results  All seven surgeries were successful without any occurrences of complications such as nerve or vascular injury, pulmonary embolism, or hematoma. The average cement injection volume was 1.8ml, and postoperative X-rays and CT scans indicated satisfactory cement filling, with two cases showing paravertebral cement leakage, but without clinical symptoms. One week postoperatively, the VAS score decreased from a preoperative average of 8.86 to 2.14, with complete pain relief in three cases, leading to the cessation of analgesic drugs, and partial pain relief in four cases, resulting in a reduction or downgrade of analgesic medications. Follow-ups ranged from 3 to 28 months, with one patient dying at 3 months postoperatively, one at 4 months, two at 6 months, one at 8 months, and one at 17 months, while one patient survived 28 months postoperatively. Postoperatively, all patients showed no worsening of local pain symptoms, and the surgical efficacy remained stable.

Conclusion  Anterior cervical mini-incision vertebroplasty is a precise and effective method for pain relief in the treatment of vertebral metastases, providing a safe approach that reduces the risk of damaging critical cervical tissues during the puncture procedure and postoperative hematoma formation. Level of Evidence lll; Retrospective Study.

Keywords:
Neoplasm Metastasis; Vertebroplasty; Cervical Vertebrae