{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:48:58Z","timestamp":1790844538897,"version":"4.1.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Metastatic spinal tumors of the atlantoaxial region are quite uncommon, and surgery is challenging. The aim in this study was to evaluate the safety and efficacy of transoral or transpedicular vertebroplasty combined with posterior fixation in C-2 metastatic disease.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors collected from a hospital database all cases of C-2 metastatic tumor treated in the period from January 2009 to December 2012. Cases with histologically confirmed metastatic disease were included, but those with epidural tumorous propagation and signs of spinal cord compression were excluded.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Five patients (3 females, 2 males) with osteolytic C-2 metastasis were eligible for this study. In 3 cases a purely posterior approach was taken to perform a dorsal open C-2 biopsy and transpedicular vertebroplasty followed by posterior occipitocervical fixation. In the other 2 cases a transoral C-2 biopsy and vertebroplasty were performed in combination with dorsal occipitocervical fixation during the same operative session. Patients were followed up with regular fluoroscopy, MRI, and CT studies as well as neurological examinations. During an average follow-up of 13 months (range 8\u201319 months), no surgical or neurological complications were associated with this combined approach. In all cases spinal stability and pain reduction were detected. The average pain score according to the visual analog scale was 3.5 after surgery (range 2\u20135); before surgery, the average score was 7 (range 6\u20138). The average volume of polymethylmethacrylate injected was 4 ml. The body and dens of the C-2 vertebra was filled more than 60% for each patient.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this small series, simultaneous intraoperative transoral or transpedicular vertebroplasty and dorsal occipitocervical fixation proved to be a safe and effective treatment for patients with osteolytic C-2 metastatic tumors. These techniques may provide excellent pain relief and improvements in quality of life. The true value of these combined techniques should be evaluated in larger series.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.8.spine13932","type":"journal-article","created":{"date-parts":[[2014,10,10]],"date-time":"2014-10-10T14:02:26Z","timestamp":1412949746000},"page":"886-891","source":"Crossref","is-referenced-by-count":9,"title":["Treatment of C-2 metastatic tumors with intraoperative transoral or transpedicular vertebroplasty and occipitocervical posterior fixation"],"prefix":"10.3171","volume":"21","author":[{"given":"Zolt\u00e1n","family":"Papp","sequence":"first","affiliation":[{"name":"Departments of Spine Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"Marosf\u0151i","sequence":"additional","affiliation":[{"name":"Neurointerventions, National Institute of Clinical Neuroscience; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Szikora","sequence":"additional","affiliation":[{"name":"Neurointerventions, National Institute of Clinical Neuroscience; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Banczerowski","sequence":"additional","affiliation":[{"name":"Departments of Spine Surgery and"},{"name":"Semmelweis University Faculty of Medicine, Department of Neurosurgery, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine13932","series-title":"Pain Physician","first-page":"35","article-title":"Vertebroplasty using transoral approach in painful malignant involvement of the second cervical vertebra (C2): a single-institution series of 25 patients","volume":"15","author":"Anselmetti","year":"2012"},{"key":"b2-spine13932","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1148\/radiology.200.2.8685351","article-title":"Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up","volume":"200","author":"Cotten","year":"1996"},{"key":"b3-spine13932","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E1143","DOI":"10.1227\/NEU.0b013e3181ee6146","article-title":"Vertebroplasty of the C2 vertebral body and dens using an anterior cervical approach: technical case report","volume":"67","author":"Dorman","year":"2010"},{"issue":"2 Suppl","key":"b4-spine13932","series-title":"J Neurosurg","first-page":"165","article-title":"Management of atlantoaxial metastases with posterior occipitocervical stabilization","volume":"98","author":"Fourney","year":"2003"},{"key":"b5-spine13932","series-title":"J Orthop Surg (Hong Kong)","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1177\/230949900501300304","article-title":"Management of malignant atlanto-axial tumours","volume":"13","author":"Fung","year":"2005"},{"key":"b6-spine13932","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.2214\/ajr.129.6.1095","article-title":"Evaluation of radiation therapy for bone metastases: pain relief and quality of life","volume":"129","author":"Gilbert","year":"1977"},{"key":"b7-spine13932","series-title":"Curr Opin Orthop","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1097\/00001433-200206000-00013","article-title":"Surgical management of cervical spine metastatic disease","volume":"13","author":"Joshi","year":"2002"},{"key":"b8-spine13932","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/S0194-5998(95)70074-9","article-title":"Transoral-transpharyngeal approach to the craniocervical junction","volume":"113","author":"Kingdom","year":"1995"},{"key":"b9-spine13932","series-title":"J Craniovertebr Junction Spine","doi-asserted-by":"publisher","first-page":"118","DOI":"10.4103\/0974-8237.77676","article-title":"Fibrous dysplasia in axis treated with vertebroplasty","volume":"1","author":"Kotil","year":"2010"},{"key":"b10-spine13932","series-title":"Pain Physician","first-page":"E427","article-title":"Vertebroplasty for treatment of osteolytic metastases at C2 using an anterolateral approach","volume":"16","author":"Sun","year":"2013"},{"key":"b11-spine13932","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1148\/radiology.199.1.8633152","article-title":"Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement","volume":"199","author":"Weill","year":"1996"},{"key":"b12-spine13932","series-title":"Clinical Biomechanics of the Spine","author":"White","year":"1978"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/21\/6\/article-p886.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/21\/6\/article-p886.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/21\/6\/article-p886.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T23:05:10Z","timestamp":1681599910000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/21\/6\/article-p886.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2014,12]]},"references-count":12,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2014.8.spine13932","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2014,12]]}}}