Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 11.
doi: 10.1007/s00330-025-11769-w. Online ahead of print.

Upper thoracic T1 and T2 percutaneous vertebroplasty: a review of 10 years of experience

Hugo Trebern  1 , Kévin Premat  1 , Pierre-Marie Chiaroni  1   2 , Evelyne Cormier  1 , Atika Talbi  1 , Mehdi Drir  3 , Jugurtha Mathout  3 , Julien Allard  1 , Mahmoud Elhorany  1 , Raphael Bonaccorsi  4 , Adrien Beth  1 , Baptiste Bonnet  1 , Jacques Chiras  5 , Frédéric Clarençon  1   2 , Eimad Shotar  6   7
Affiliations

Upper thoracic T1 and T2 percutaneous vertebroplasty: a review of 10 years of experience

Hugo Trebern et al. Eur Radiol. .

Abstract

Objective: T1 and T2 upper thoracic vertebroplasties (UTVs) represent a technical challenge due to various anatomical factors that impact the quality of fluoroscopic control and potentially increase procedural risks. The aim of this study is to report the feasibility and safety of T1-T2 UTV.

Materials and method: All patients having undergone UTV (T1 or T2) from March 2012 to September 2021 in a single tertiary care teaching hospital were included. Patients without a post-procedure control CT scan were excluded. The following data were retrospectively collected: demographics, procedure indications, vertebroplasty level(s), bone needle position, procedure details, vertebral body volume, intracorporeal cement volume, complications (CIRSE score), and clinical follow-up. The primary outcome was procedural technical success, defined as achieving both a correct bone-needle trajectory avoiding the spinal canal and endplate-to-endplate cement filling, without any adverse events.

Results: Forty patients (19 females, 21 males, average age 65 years [range 18-89]) were included, totaling 49 vertebrae with 31/49 (63%) T1 vertebroplasties. Of the 49 UTVs, 30 (61%) were performed to treat bone metastases from various cancers. The primary outcome, technical success, was achieved in 39/49 (79.5%) of the UTVs. Satisfactory bone needle trajectory was reported in 73/80 (91%) of the approaches, and endplate-to-endplate filling was achieved in 82% of cases. Cement leakage was observed on 84% of the post-operative control CT scans. Based on the CIRSE classification, no adverse events were reported.

Conclusion: UTV under fluoroscopic control is a challenging procedure, but it is technically achievable and safe. Procedure optimization is paramount to overcoming anatomical difficulties.

Key points: Question This study aims to report the feasibility and safety of upper thoracic vertebroplasty (UTV) of T1 and T2 vertebrae, a challenging procedure, seldom reported. Findings T1 and T2 UTV is technically feasible and safe under fluoroscopic guidance. Clinical relevance T1 and T2 UTV remains a complex procedure despite demonstrating technical success and a low complication rate. The main limit to fluoroscopy-guided UTV, even with procedure optimization, is the quality of lateral-projection fluoroscopic control.

Keywords: Fluoroscopy; Radiology (interventional); Safety; Thoracic vertebrae; Vertebroplasty.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Eimad Shotar. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was waived by the Institutional Review Board. Ethical approval: Institutional Review Board approval was obtained. Study subjects or cohorts overlap: Some study subjects or cohorts have been previously reported in the screening of a study [35], but none had been included. Methodology: Retrospective Observational Performed at one institution

References

    1. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168 - PubMed
    1. Ahlhelm F, Omidi R (2016) [Kyphoplasty and vertebroplasty for spinal trauma]. Radiologe 56:691–697. https://doi.org/10.1007/s00117-016-0118-6 - PubMed
    1. Clark W, Bird P, Gonski P et al (2016) Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet 388:1408–1416. https://doi.org/10.1016/S0140-6736(16)31341-1 - DOI - PubMed
    1. Cheung G, Chow E, Holden L et al (2006) Percutaneous vertebroplasty in patients with intractable pain from osteoporotic or metastatic fractures: a prospective study using quality-of-life assessment. Can Assoc Radiol J 57:13–21 - PubMed
    1. Ghobrial GM, Eichberg DG, Kolcun JPG et al (2017) Prophylactic vertebral cement augmentation at the uppermost instrumented vertebra and rostral adjacent vertebra for the prevention of proximal junctional kyphosis and failure following long-segment fusion for adult spinal deformity. Spine J 17:1499–1505. https://doi.org/10.1016/j.spinee.2017.05.015 - DOI - PubMed

LinkOut - more resources