TRANSORAL KYPHOPLASTY FOR TUMORS IN C2

Abstract

Object. Our purpose is to describe a new surgical technique, the transoral kyphoplasty, that we performed in 3 cases of tumors in C2.

Materials and Methods. From February 2004 to January 2006 3 cases of C2 tumoral localizations did not show healing after 6 months of conservative treatments. To reduce pain and avoid both C2 collapse and prolonged immobilization transoral kyphoplasties were performed.

Results. There were no complications and/or complaints related to the procedure. There were no C2 related symptoms or neurological problems. The first patient died 8 months after surgery due to unrelated causes. The second and the third are alive and, follow ups of 2 years and 8 months respectively, reveal good and pain-free cervical motion, with no findings regarding pathologic mobility/instability on X-ray and CT.

Discussion. The management of tumors of the C2 body is still controversial. In cancer patients non-operative treatment could fail. In these cases the literature recommends internal fixation (anterior or posterior), percutaneous vertebroplasty, or transoral vertebroplasty [1–4]. Anatomically, the transoral route is the most straightforward percutaneous access to the C2 body [4]. In our cases, after conservative treatment failure, we performed the transoral kyphoplasty to avoid major surgical procedures, and considering kyphoplasty an improvement of the vertebroplasty. While maintaining the normal cervical spine anatomy, and avoiding arthrodesis or fixation that reduce the cervical spine range of motion, in the thoracolumbar spine kyphoplasty versus vertebroplasty is correlated with a reduction in the complication rate [5].

Conclusions. Transoral kyphoplasty could be considered a safe, quick and effective treatment in reducing pain and avoiding vertebral collapse in patients with tumors in C2, not responding to non-operative treatment.