Minimal Invasive Percutaneous Kyphoplasty of C1 Lytic Lesion Using an Intraoperative 3D Imaging-Based Navigation System and Fluoroscopy

Abstract

Background: Percutaneous kyphoplasty is a minimally-invasive techniques that aim to provide pain relief and bone stabilization by the injection of cement. Metastatic lesions of the atlas treated by this technique has been described in only few articles. Objective: We describe the use of kyphoplasty in a painful osteolytic lesion located in the left mass lateral of C1 with a postero lateral approach using 3D CT-scann intraoperative navigation system and fluoroscopy. Methods: A 58 year-old woman with metastastic breast neoplastic which admitted for treatment severe left-sided suboccipital exacerbated by head rotation and neck pain refractory to conventional medical treatment painkillers. CT scan and magnetic resonance imaging of the cervical spine revealed osteolytic destruction the left lateral mass of C1 . The patient underwent a percutaneous kyphoplasty managed using polymethylmetacrylate bone cement. Results: The patient reported post operative substantial pain relief . CT scan showed adequate filling of the osteolytic lesion without the obvious leakage of bone cement. the patient showed no clinical complications, while Clinical follow-up at 3 months revealed that this pain condition was improved and maintained. Conclusion: Minimally invasive percutaneous kyphoplasty using an intraoperative 3D navigation system and fluroscopy with postero lateral approach is a safe and effective alternative reducing post-operative morbidity and effective possibility in selected patients with C1 metastasis