Percutaneous vertebroplasty for treatment of osteolytic metastases of the C2 vertebral body using anterolateral and posterolateral approach

Percutaneous vertebroplasty (PVP) of C2 vertebral body is a challenging procedure. The aim of this retrospective study was to evaluate the feasibility, safety, and efficacy of PVP for the C2 osteolytic metastases using anterolateral and posterolateral approaches. Ten patients (8 male, 2 female) with C2 metastases were treated with PVP under local anesthesia. Anterolateral route was used under the guidance of fluoroscopy in 9 cases, and posterolateral route was used under the guidance of CT in 1 case. Pain intensity was scored on a scale ranging from 0/10 (no pain) to 10/10 (maximum pain intensity). The mean volume of cement injected was 3 ± 0.8 mL (range, 2.0-4.0 mL), with average vertebral filling of more than 70%. Cement leakage was detected in 4 treated vertebrae. Pain improvement and spine stability were achieved in all patients. In conclusion, PVP of C2 using anterolateral approach is a feasible and minimal invasive procedure for treatment of patients with C2 osteolytic metastases. Posterolateral approach is a safe and effective option for PVP of C2 when hyperextension of the cervical spine is contraindicated or difficult to achieve.