Traitement par kyphoplastie ouverte d’une métastase de C2 : cas clinique et note technique

Fuentès, S.; Metellus, P.; Pech-Gourg, G.; Dufour, Henry; Grisoli, F

doi:10.1016/j.neuchi.2008.06.002

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…Balloon kyphoplasty creates a space for cement filling by decreasing the filling pressure, and allows injection of more viscous cement and decreases paravertebral and intradiscal cement extravasation [ 11 ]. Balloon kyphoplasty for cervical spinal metastasis was described by Fuentes et al [ 14 ] in 2009; however, there are few reports of surgical efficacy of this technique ( Table 2 ) [ 22 - 24 ]. To our knowledge, this study reports the largest series in the literature with excellent results in more than 80% of the patients, mean decrease in neck pain score by 5 points, and more than 50% reduction in pain medication and opioid use.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical technique for kyphoplasty for the cervical spine was described by Fuentes et al [ 14 ] in 2009. With the patient in dorsal decubitus position and under general anesthesia, a right anterolateral approach at the approximate level of the cricoid cartilage was undertaken, keeping in mind the orientation of the odontoid for C2 kyphoplasty (exactly like a C2 odontoid screw placed in fractures).…”

Section: Methodsmentioning

confidence: 99%

“…This treatment has been shown to be effective for the palliative treatment of metastatic spinal disease and even for the treatment of osteoblastic lesions [ 12 ]. Recent reports have shown promising results of kyphoplasty for cervical spine metastasis [ 13 , 14 ]. The objective of this study was to report the single-center experience with the palliative treatment of cervical metastasis using cervical kyphoplasty.…”

Section: Introductionmentioning

confidence: 99%

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Anterolateral Cervical Kyphoplasty for Metastatic Cervical Spine Lesions

et al. 2018

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Study DesignRetrospective case series.PurposeTo evaluate the clinical and radiological efficacy of anterolateral kyphoplasty for cervical spinal metastasis.Overview of LiteratureAlthough the spine is the third most common site of tumor metastasis, the cervical spine is the least commonly affected (incidence, 10%–15%). Surgical decompression is highly challenging because of the proximity of neural and vascular elements. Kyphoplasty for cervical spine metastasis has been described in small case reports with promising results.MethodsRetrospective analysis of a prospective collected single-center spine metastasis database was done for cervical kyphoplasty cases. Data pertaining to age, sex, primary tumor diagnosis, modified Tokuhashi score, Spinal Instability Neoplastic Score (SINS), preoperative Visual Analog Scale (VAS) score, and analgesic medication were extracted. Postoperative data included VAS score at postoperative day 1, duration of hospitalization, self-reported functional outcome, and VAS score at the last follow-up.ResultsEleven patients (mean age, 62.5 years) with cervical spine metastases were treated with 15-level kyphoplasty. Mean Tokuhashi score was 8.1, and mean SINS was 7.85. Mean preoperative pain score was 7.1, and 82% of patients used opioid analgesics. Mean total bleeding volume was 100 mL. Mean complication-free length of stay was 2.6 days with a decrease in postoperative pain (VAS score=2.8, p <0.05). There was a 56% decrease in opioid dosage and the number of consumed analgesics (1.09, p =0.004). Eighty-two percent of the patients reported excellent improvement at the last follow-up self-assessment.ConclusionsTo our knowledge, this case series represents the largest series of vertebral augmentation using balloon kyphoplasty for cervical spinal metastasis. This technique is associated with low postoperative complications as well as significant decrease in pain, use of opioids, and length of hospital stay. The main indications for vertebral kyphoplasty are lytic lesions of the cervical spine, painful lesions refractory to medical treatment, SINS score of 6–10, and absence of posterior wall defect.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anterolateral Cervical Kyphoplasty for Metastatic Cervical Spine Lesions

et al. 2018

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“…8 Kyphoplasty alone has also been described in 7 cases for painful lytic lesions, either metastases or of myelomatous origin. 11,14,15,26,31 This method allows for preferential determination of placing the cement and thus limiting the risks of leakage. The surgical approach allows for control over the vascular bundles, and the anterolateral cervical approach limits the risks of infection, such as those associated with the transoral approach.…”

Section: Discussionmentioning

confidence: 99%

“…8,10,30,38,43,49 Another technique using these 2 routes has also been described, kyphoplasty, which allows for better control of the injection zone with cement by the creation of a cavity. 11,14,15,26,31 We decided to combine the 2 techniques of anterior screw fixation of the odontoid and balloon kyphoplasty to obtain satisfactory compression and limit the chances of subsequent displacement in 2 female patients approximately 90 years of age with severe osteoporosis.…”

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confidence: 99%

Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients

Terreaux¹,

Loubersac²,

Hamel³

et al. 2015

SPI

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Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid. Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery. After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability. This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.

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Rolle und Grenzen der Vertebro-/Kyphoplastie im Metastasenmanagement der Wirbelsäule

et al. 2012

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The spine is the most common site for skeletal metastases. Tumor-induced osteolysis may lead to pain, dysfunction and ultimately vertebral fracture. In some patients conventional surgery is not suitable because of the palliative therapy approach. Just for this patient population it was shown that cement augmentation of the vertebra is an effective therapy option and plays an important role. Nevertheless, cement augmentation of the vertebra has its limitations and should only be applied by appropriate indications.

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Traitement par kyphoplastie ouverte d’une métastase de C2 : cas clinique et note technique

Cited by 10 publications

References 10 publications

Anterolateral Cervical Kyphoplasty for Metastatic Cervical Spine Lesions

Anterolateral Cervical Kyphoplasty for Metastatic Cervical Spine Lesions

Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients

Rolle und Grenzen der Vertebro-/Kyphoplastie im Metastasenmanagement der Wirbelsäule

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