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Percutaneous Vertebroplasty for Metastatic Involvement of the Axis

Francisco Mont’Alvernea, Jean-Noel Valléea, Evelyne Cormiera, Remy Guillevina, Hector Barragana, Betty Jeana, Michelle Rosea and Jacques Chirasa

a From the Department of Neuroradiology, Groupe Hospitalier Pitie-Salpetriere, Paris, France



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  		FIG 1. 47-year-old man with a multimetastatic pheochromocytoma.

A and B, Saggital and coronal CT reconstructions show an osteolytic involvement of the C2 vertebral body with a thinned posterior wall.

C and D, Saggital and coronal CT reconstructions, obtained after percutaneous vertebroplasty, show a homogeneous distribution of cement within the vertebral body with an extension toward the dens. Note cement leakage in soft tissues on the right side (arrow).



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  		FIG 2. Breast cancer with multiple spinal involvements.

A, Lateral radiograph obtained after placement of the needle shows its oblique trajectory and the approach to C2. Note that the needle is placed at the central part of the vertebral body.

B, Lateral radiograph, obtained after percutaneous vertebroplasty, shows a satisfactory opacification of the vertebral body but also a cement leakage (arrows).

C, Axial CT scan, obtained after percutaneous vertebroplasty, shows cement leakage in the epidural space (short arrow), as well as leakage close to the C1-C2 joint (long arrow). The latter caused a transient occipital neuralgia.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X