Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

OBJECTIVE: To report our experience of treating painful C1 osteolytic lesions with cement augmentation via a lateral approach under fluoroscopic guidance. MATERIALS AND METHODS: Nine consecutive patients (eight men and one woman; mean age: 56.7±13.2 years) with osteolytic lesions of the atlas who underwent cementoplasty via a lateral approach were enrolled in this study. The technical success rate, operation time, and complications were recorded. Visual analogue scale (VAS) and Neck disability index (NDI) were used to evaluate the pain relief and neck function status pre-procedure (baseline) and post-procedure (at 3 days; after 1, 3, 6, 12, 18, and 24 months; and at the last follow-up). RESULTS: The procedure was technically successful without any complications in all patients. The mean procedure time was 44.3±7.8 min. There were three cases of bone cement leakage, but no clinical symptoms. The mean VAS score decreased from 6.7±1.0 before the procedure to 3.7 three days after the procedure. The mean NDI score decreased from 67.3±11.2 before the procedure to 39.3±13.7 three days after the procedure. The VAS and NDI scores decreased at each follow-up time point, and the difference was statistically significant compared with the scores before the procedure (P<0.01). CONCLUSION: Fluoroscopy-guided lateral approach is a feasible, safe, and effective method for treatment of osteolytic lesions of the atlas and can relieve pain and stabilize the bone.