To investigate the clinical safety, efficacy and feasibility of percutaneous vertebroplasty (PVP) guided by CT and C-arm fluoroscopy for the treatment of painful cervical metastasis.

PVP was performed under CT and C-arm guidance in 10 patients with painful cervical metastases. A total of 11 diseased vertebral bodies were detected, which distributed in the C3 (n = 3), C4 (n = 1), C5 (n = 2), C6 (n = 3) and C7 (n = 2). Under CT guidance, an 18G needle was punctured into the target vertebral body, and then the patient was moved to a C-arm digitalized angiographic system. Polymethylmethacrylate bone cement was injected into the vertebral body under constant lateral fluoroscopy with the C-arm fluoroscopy system. Under C-arm fluoroscopy monitoring,vertebral bodies were injected polymethyl methacrylate bone cement.The amount of bone cement used during PVP and any complications related with PVP were recorded. The score of visual analogue scale point (VAS) before PVP, 1 week, 1 and 3 months after PVP was recorded respectively. The difference of VAS score between the different time points was analyzed using repeated measures of ANOVA.

The technical success of both needle puncturing and bone cement injection was achieved in all patients. The mean amount of bone cement injected in each diseased vertebra was 1.7 ± 0.3 mL(1.2~2.2 mL). Marked pain relief was quickly obtained in all 10 patients. The VAS score before PVP, 1 week, 1 month and 3 months after PVP was 8.3 ± 0.7, 3.0 ± 0.7, 2.7 ± 0.5, 3.0 ± 0.6, respectively ,and the VAS score after PVP decreased significantly compared to the pre-treatment (F = 215.705, P < 0.05). No major complications occurred in this series, except for asymptomatic bone cement leaking around vertebra which appeared in 3 vertebral bodies.

Percutaneous vertebroplasty guided by CT and C-arm is a safe and effective technique for the treatment of painful cervical vertebral body metastasis.