Three-Dimensional C-Arm Computed Tomography Combined with Fluoroscopic Guided Pediculoplasty for Treatment of Vertebral Body Metastasis with Lytic Pedicle

• Published in: Technology in cancer research & treatment Vol. 11; no. 2; pp. 169 - 174
• Main Authors: Sun, Gang, Jin, Peng, Li, Min, Liu, Xunwei, Li, Fandong, Xie, Zhiyong, Ding, Juan, Peng, Zhaohui
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.04.2012; Adenine Press
• Subjects: Aged; Biological and medical sciences; Bone Diseases - diagnostic imaging; Bone Diseases - pathology; Bone Diseases - surgery; Diseases of the osteoarticular system; Female; Fluoroscopy - methods; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Lumbar Vertebrae - surgery; Male; Medical sciences; Middle Aged; Neoplasm Staging; Neoplasms - diagnostic imaging; Neoplasms - pathology; Neoplasms - surgery; Orthopedic surgery; Pain Measurement; Prognosis; Retrospective Studies; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - secondary; Spinal Neoplasms - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed - methods; Tumors of striated muscle and skeleton; Vertebroplasty - methods; Vertebroplasty; Pediculoplasty; 3-dimensional C-arm CT; Spine; Secondary neoplasms; Human; Spinal metastasis; Pedicle of the cervical vertebral arch; Radiodiagnosis; Diseases of the osteoarticular system; Vertebral body; Radioscopy; Tridimensional tomography; Spine disease; Malignant tumor; Osteolysis; Guidance; Plasty; Treatment; Surgery; Medical imagery; Computerized axial tomography; Cancer
• ISSN: 1533-0346; 1533-0338
• DOI: 10.7785/tcrt.2012.500246

The aim of this retrospective study was to evaluate a percutaneous pediculoplasty (PP) technique, using 3-dimensional C-arm CT reformation combined with fluoroscopic guidance for patients presented vertebral body metastasis with lytic pedicle. Thirteen patients (average age 57.8 years) were treated through lytic pedicle approach in our study. Subjective good and partial pain relief was reported with Visual Analogue Scale reduction ≥4 in 11/13 patients at 1 month after procedure, two patients with insufficient pain relief died from clinical complications unrelated with PP at 3 month follow-up. Pain relief was maintained in 10 patients at 6 month post-procedural follow-up. One patient died from underlying disease unrelated with the procedure at 5 month follow-up. PP through the lytic pedicle approach under 3-dimensional C-arm CT reformation combined with fluoroscopic guidance was a feasible, safe, and minimally invasive procedure that could provide both the precise control of needle placement and cement injection with one imaging system.