Percutaneous vertebroplasty in tumoral spinal fractures with posterior vertebral wall involvement: Feasibility and safety

Purpose: to evaluate the technical feasibility and safety of CT and fluoroscopy guided percutaneous vertebroplasty in the treatment of tumoral vertebral fractures with posterior wall involvement. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-three consecutive adult patients (35 women, 28 men; mean age +/- standard deviation: 69 years +/-) with tumoral spinal fractures that compromised the posterior wall were treated by means of percutaneous vertebroplasty with CT and fluoroscopy guidance. Only local anesthesia was used during these procedures. Postoperative outcome was assessed using the Kostuik index. Results: Sixty-three vertebroplasties were performed on thirty-four thoracic (54%), twenty-six lumbar (41%), and three (5%) cervical vertebrae. The etiologies of the fractures were metastasis in twenty-eight (44%), myeloma in twenty-five (40%) and hemangioma in ten (16%). Almost all fractures (94%) were consolidated after vertebroplasty (score of Kostuik < 3) (p < 0.001). No major complications were reported in our series of cases. Conclusion: This study suggests that tumoral spinal fractures with posterior vertebral wall involvement can be successfully and safely treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.