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Posterior decompression and occipitocervical fixation adopted by intraoperative vertebroplasty for metastatic involvement of the axis.

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Posterior decompression and occipitocervical fixation adopted by intraoperative vertebroplasty for metastatic involvement of the axis.

BMC Musculoskelet Disord. 2018 Jan 11;19(1):11

Authors: Wu X, Tan M, Qi Y, Yi P, Yang F, Tang X, Hao Q

Summary
BACKGROUND: Metastases to the higher cervical backbone have been not often reported within the literature. Nevertheless, metastases to this space could trigger spinal instability and rope compression, which in flip may end up in respiratory failure and neurological dysfunction. The current examine investigated the efficacy and security of posterior decompression and occipitocervical fixation adopted by intraoperative vertebroplasty for this illness.
METHODS: This was a retrospective examine that included 10 sufferers with metastatic involvement of the axis from March 2002 to Could 2014. All instances introduced with occipitocervical ache: 5 sufferers with compressive myelopathy and 6 sufferers with radiculopathy. Japanese Orthopedic Affiliation (JOA) scores and Visible Analogue Scale (VAS) have been used to judge the advance of neurological perform and ache depth, respectively.
RESULTS: All sufferers underwent posterior decompression and occipitocervical fixation adopted by intraoperative vertebroplasty. The VAS scores and JOA scores each improved postoperatively, from eight.2?±?zero.four to 2.three?±?zero.2 and from 10.1?±?2.2 to 14.2?±?2.9, respectively. Moreover, the advance price of JOA was 52.four?±?1.eight%. The imply general survival was 12.eight months. The median survival time was 7 months. The 6-month and 12-month survival charges have been 70% and 40%, respectively. The imply period of operation was 182 min and blood loss was 450 mL. The imply quantity of bone cement injected was four.zero mL. The cement extravasation was noticed in just one affected person with out medical signs. One affected person developed tumour recurrence and died 1 month later.
CONCLUSIONS: Posterior decompression and occipitocervical fixation adopted by intraoperative vertebroplasty was a protected and helpful palliative methodology with comparatively much less invasion to deal with metastatic involvement of the axis.

PMID: 29325524 [PubMed – in process]

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