• Zhen-Yong Ke, Yang Wang, Yue-Long Zhong, Liang Chen, and Zhong-Liang Deng.
• Department of Orthopaedics, Second Affiliated Hospital of Chongqing Medical University, China.
• Pain Physician. 2015 May 1;18(3):E347-53.

BackgroundPercutaneous pediculoplasty (PP) consists of the injection of Poly(methyl methacrylate) (PMMA) into the fractured pedicle or lytic vertebral pedicle lesions, as a technique derived from vertebroplasty.ObjectivesTo evaluate the short-term analgesic effect of percutaneous vertebroplasty (PV) and percutaneous pediculoplasty (PP) in patients with lytic vertebral body and pedicle lesions of metastatic tumors.Study DesignSingle-center retrospective observational study.SettingAn interventional pain management practice, a medical center, major metropolitan city, China.MethodsSingle-center retrospective observational study of all patients managed with PV and PP for painful vertebral body and pedicle metastatic tumors between 2007 and 2013. For each patient, symptom duration and pain intensity were recorded. PP was performed under local analgesia, in the prone position, with C-arm fluoroscopy guidance. The mixture of PMMA and Doxorubicin was delivered into the vertebral body with a non-beveled needle for the initial treatment followed by the mixture delivery into the lytic pedicle during needle withdrawal.ResultsNine patients (5 women, 4 men) were enrolled in the study with a mean age of 65.9 years (range 57 - 75). Technical success was defined as the ability to access the lesion using the approach. A positive clinical response for pain relief was achieved in these patients in whom vertebroplasty and pediculoplasty had been performed. Pain level was not significantly reduced in 3 patients in whom just vertebroplasty has been performed because the medial wall of the pedicle was destroyed by the metastatic lesion.LimitationsThis study is limited by its sample size.ConclusionsPV and PP via the transpedicular approach for infiltrated vertebral bodies and infiltrated pedicles of metastatic tumors may be considered a valid therapeutic option.

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