Stereotactic CT image guidance and biplanar fluoroscopy for transoral C2 vertebroplasty and direct anterolateral subaxial vertebroplasty: a surgical technique note on access to the axial and subaxial spine

Miki Katzir, Nguyen Hoang, Eric Bourekas, Ricardo Carrau, Ehud Mendel

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Metastatic cervical spine disease can cause compression fractures, cervical spine instability, and pain. Vertebroplasty can stabilize a fracture, reduce the pain associated with a compression fracture, prevent or stop the progression of a fracture, thus avoiding cervical spine fixation, and decreased mobility. Transoral C2 vertebroplasty is less invasive than open fusion surgery, but it poses its own risk of infection and cement leak in this highly sensitive area. Methods: The image guidance setup consisted of the Stryker NAV3i navigation system, Stryker CranialMask tracker, and the CranialMap 3.0 software combined with biplanar fluoroscopy. Results: The patient’s neck pain has completely resolved immediately after the surgery. There were no complications. Conclusion: Quality of life preservation is paramount in the management of metastatic spine disease. Vertebroplasty of osteolytic lesions can both relieve pain and restore stability, thus avoiding permanent stiff cervical collar, halo vest, or upfront occipitocervical fusion. With the increasing availability of surgical navigation systems, its use combined with biplanar fluoroscopy for performing transoral C2 vertebroplasty seems to be an adequate treatment in selected cases for pain relief, stabilization, and maintaining quality of life in the complex cancer population with C2 pathological fractures. The article describes as well vertebroplasty of the subaxial spine through a conventional anterior approach which again seems to be adequate in the treatment of spinal pathological fractures. [Figure not available: see fulltext.]

Original languageEnglish (US)
Pages (from-to)2533-2536
Number of pages4
JournalActa Neurochirurgica
Volume162
Issue number10
DOIs
StatePublished - Oct 1 2020
Externally publishedYes

Keywords

  • C2 fracture
  • Spine metastases
  • Transoral
  • Vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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