CT guided direct transoral approach to C2 for percutaneous vertebroplasty.

Abstract

Percutaneous vertebroplasty is a well-established procedure consisting of the percutaneous injection of a biomaterial, usually Polymethyl methacrylate (PMMA), into a vertebral body. In most cases, this procedure affords significant pain relief and strengthens the bone. Vertebroplasty is most typically performed successfully with patients with acute compression fractures. We report a case of percutaneous vertebroplasty via the transoral approach, performed with computed axial tomography (CT) scan guidance. The procedure was performed in a 74-year-old male with a C2 vertebral body lytic lesion. This uncomplicated, minimally invasive procedure relieved the patient's pain. The transoral route is the most direct operative approach to the pathology in the upper cervical spine. When used with the CT scanner to facilitate accurate placement of the needle, the transoral approach provides a safe and precise operative approach to the upper cervical spine.