Abstract WP55: A Comparison of Outcomes in Patients Selected for Endovascular Stroke Treatment with and without the Aid of CT Perfusion Imaging

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Gregory Ferenz ◽  
Raymond Reichwein
Keyword(s):  
Clinical Outcomes ◽  
Ct Perfusion ◽  
Small Sample Size ◽  
Medical Center ◽  
Outcome Data ◽  
Small Sample ◽  
Treatment Selection ◽  
Control Group ◽  
Stroke Treatment ◽  
Significant Difference

Background: Selection of patients for endovascular stroke treatment has traditionally been based on time since symptom onset. CT perfusion (CTP) imaging has raised the possibility of patient selection on objective measures other than time from stroke onset. However, previous studies have failed to show significant outcome improvement in patients selected for endovascular stroke treatment based on CTP, but have been limited by small sample size, lack of outcomes past time of discharge, or lack of control group. Objective: To determine if endovascular stroke treatment selection with the aid of CTP is associated with improved clinical outcomes at 90 days as compared to patients undergoing endovascular stroke treatment without the aid of CTP. Methods: This study retrospectively reviewed a prospectively collected database of all patients who underwent endovascular stroke treatment at Penn State Hershey Medical Center between 1/1/2009 and 12/31/2011. Patients with posterior circulation strokes and those enrolled in other treatment trials were excluded. Patients were divided into two groups based on whether they had undergone a CTP study prior to endovascular stroke treatment or not. The variables measured included age, sex, and NIHSS on admission. Outcome data measured from the patients 90 day post stroke follow up appointments included an NIHSS improvement by 4 or more, a modified Rankin Score (mRS) of 2 or less, and mortality. Results: Of 41 patients included in the study, there was no significant difference in outcomes at 90 days as measured by an improvement of NIHSS of 4 or more (p=0.106) or modified Rankin score of 0-2 (p=0.475). Table 1 summarizes the results. Conclusion: Endovascular stroke treatment selection with the use of CTP was not associated with improved clinical outcomes at 90 days as measured by NIHSS improvement of 4 or more or a mRS of 0-2.

scholarly journals 1611. Evaluating Clinical Outcomes and Efficacy of Daptomycin in Combination with a Beta-Lactam for the Treatment of Vancomycin-Resistant Enterococcus (VRE) Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S799-S800
Author(s):  
Nerea Irusta ◽  
Ana Vega ◽  
Yoichiro Natori ◽  
Lilian M Abbo ◽  
Lilian M Abbo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Primary Outcome ◽  
Small Sample Size ◽  
Univariate Analysis ◽  
Small Sample ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
Secondary Outcomes ◽  
Related Mortality

Abstract Background In-vitro studies have shown synergistic bactericidal activity with daptomycin (DAP) plus β-lactam antimicrobials against vancomycin resistant enterococci (VRE). There is a paucity of data regarding clinical outcomes with this combination in VRE bloodstream infections (BSI). The purpose of this study was to assess the efficacy of DAP plus a β-lactam with in-vitro activity vs. other therapies for treatment of VRE BSI. Methods IRB-approved, single-center, retrospective study of patients with VRE BSI from 01/2018-09/2019. Patients were excluded if < 18 years old, pregnant, or incarcerated. The primary outcome was time-to-microbiological clearance. Secondary outcomes included infection-related mortality, 30-day all-cause mortality, and incidence of recurrent BSI within 30 days of index culture. Targeted DAP doses were ≥ 8mg/kg and based on MIC. Factors associated with significance for outcomes, via univariate analysis, were evaluated with multivariable logistic regression (MLR), removed in a backward-step approach. Results A total of 85 patients were included, 23 of which received DAP plus a β-lactam. The comparator arm included linezolid or DAP monotherapy. Patients with combination therapy had significantly higher Charlson Comorbidity Index (CCI) (p=0.013) and numerically higher Pitt Bacteremia scores (PBS) (p=0.087) (Table 1). There was no difference seen in the primary outcome (Table 2). Secondary outcomes are provided in Table 2. The presence of polymicrobial infection and higher PBS were significantly associated with infection-related mortality (p=0.008 and p=0.005, respectively) by MLR. A Mann Whitney U test indicated that presence of infection-related mortality was greater for patients with higher MICS (U=20.5, p=0.06). The presence of an underlying source may be related to recurrence of BSI (p=0.075). Table 1: Patient Characteristics Table 2. Primary and Secondary Outcomes Conclusion We did not find a significant difference in time-to-microbiological clearance, although patients treated with DAP and a β-lactam had higher CCI and PBS. These results are limited by retrospective design, small sample size, and potential selection bias. Prospective randomized studies are needed to further validate these findings. Disclosures All Authors: No reported disclosures

scholarly journals Acupuncture for Chronic Pain-Related Insomnia: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Fushui Liu ◽  
Jianyu You ◽  
Qi Li ◽  
Ting Fang ◽  
Mei Chen ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Sample Size ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Small Sample ◽  
Control Group ◽  
Large Sample Size ◽  
Cure Rate ◽  
Significant Difference

Objectives. Acupuncture has been widely used to relieve chronic pain-related insomnia (CPRI). However, the efficacy of acupuncture for CPRI is uncertain. The purpose of this study was to evaluate the efficacy of acupuncture for CPRI. Methods. Seven electronic databases were searched from inception to December 2018. Randomized controlled trials (RCTs) were included if acupuncture was compared to sham acupuncture or conventional drug therapies for treating CPRI. Two reviewers screened each study and extracted data independently. Statistical analyses were conducted by RevMan 5.3 software. Results. A total of nine studies involving 944 patients were enrolled. The pooled analysis indicated that acupuncture treatment was significantly better than control group in improving effective rate (OR = 8.09, 95%CI = [4.75, 13.79], P < 0.00001) and cure rate (OR = 3.17, 95%CI = [2.35, 4.29], P < 0.00001), but subgroup analysis showed that there was no statistically significant difference between acupuncture and sham acupuncture in improving cure rate (OR =10.36, 95% CI [0.53, 201.45], P=0.12) based on one included study. In addition, meta-analysis demonstrated that acupuncture group was superior to control group in debasing PSQI score (MD = -2.65, 95%CI = [-4.00, -1.30], P = 0.0001) and VAS score (MD = -1.44, 95%CI = [-1.58, -1.29], P < 0.00001). And there was no significant difference in adverse events (OR =1.73, 95%CI = [0.92, 3.25], P =0.09) between the two groups. Conclusions. Acupuncture therapy is an effective and safe treatment for CPRI, and this treatment can be recommended for the management of patients with CPRI. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large sample size are recommended in future.

ABCA3 Expression Predicts Response to Gemtuzumab Ozogamicin in AML

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3946-3946 ◽  
Author(s):  
Antony Ceraulo ◽  
Aminetou Mint-Mohamed ◽  
Delphine Maucort-Boulch ◽  
Etienne Paubelle ◽  
Xavier Thomas ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Relapse Rate ◽  
Small Sample Size ◽  
Univariate Analysis ◽  
Gemtuzumab Ozogamicin ◽  
Small Sample ◽  
Control Group ◽  
Prognostic Impact ◽  
Significant Difference

Abstract Background. The ATP binding cassette transporter 3 (ABCA3) has been recently found to induce a significant reduction in cytotoxicity following exposure to anthracyclines, mitoxantrone, etoposide, Ara-C, vincristine, and rituximab. ABCA3 acts through the modulation of multivesicular bodies (MVB) and contributes to drug sequestration in late endosomal organelles, i.e. MVB and lysosomes. Studies having investigated the prognostic impact of ABCA3 expression in AML have yielded conflicting results as ABCA3 expression has both been reported to exert unfavorable or neutral effects on patient outcomes. In addition, the small sample size of these studies precluded the use of multivariate analyses. Methods. Our goal was to investigate the prognostic impact of ABCA3 expression in adult patients with AML treated with IC with or without gemtuzumab ozogamicin (GO). To this end we investigated the relationship between ABCA3 expression and EFS in a representative series of 221 AML homogeneously treated in the ALFA-0701 trial. qRTPCR amplification of conserved ABCA3 mRNA sequences, as identified with FasterDB database, was performed with GUS and ABL as reference genes. Primer sets were complementary to conserved ABCA3 exons 6-7 and exon 19-20 junctions. Patients were given a 3+7 induction course without (control group, n=110) or with fractionated intravenous GO (n=111) (Castaigne S, Lancet 2012; 379:1508-1516). Results. Among the 278 randomized patients, 221 had available bone-marrow diagnostic samples with high-quality RNA. The same benefits associated with GO were observed in the 221 patients from the present study as in the entire trial population. Overall, median age, CR rate, relapse rate, median follow-up, 3-years EFS were 62.1 years, 76.5%, 66%, 47.45 months, 28±3%, respectively. There was no significant difference in the level of ABCA3 expression between responders and non-responders. In the 169 responders, ABCA3 expression at diagnosis was more than 3-fold higher in the 111 remitters who subsequently relapsed than in the 58 patients who remained in persistent CR (p=0.033). The level of ABCA3 expression was significantly lower in ELN favorable group than in intermediate and adverse risk AML (p= 0.004) and negatively correlated with CD33 expression (R=-0.272, p<10-4). Through univariate analysis, higher ABCA3 expression was associated with shorter EFS (3-years: 22±3 vs 45±7 % p=0.002). Multivariate analysis identified age, treatment arm, and ELN risk group as independent prognostic factors for EFS. In the control group, there was no significant association between ABCA3 expression and CR rate, relapse rate, and EFS. In the 111 patients within the GO arm, there was no significant difference in the level of ABCA3 expression between responders and non-responder whereas in the 89 responders, ABCA3 expression at diagnosis was more than 7-fold higher in the 53 remitters who subsequently relapsed than in the 36 patients who remained in persistent CR (p=0.006). Through univariate analysis, higher ABCA3 expression was associated with shorter EFS (3-years: 22±5 vs 64±9 % p=0.0002). Multivariate analysis identified ABCA3 expression, cytogenetics, CD33 expression, and ECOG as independent prognostic factors for EFS (Figure 1). Conclusion. WhileABCB1 has been previously found to attenuate GO-induced cytotoxicity in AML cells (Walter RB, Blood 2003; 102:1466-1473), present results indicate that higher ABCA3 expression independently predicts poor outcome in AML patients treated with fractionated GO and intensive chemotherapy (IC). GO is an anti-CD33 antibody carrying a toxic calicheamicin derivative that, after hydrolytic release within lysosomal vesicles, induces DNA strand breaks, apoptosis, and cell death. Whether the clinical effect of ABCA3 expression relies on the modulation of CD33 internalization, calicheamicin release or combination thereof is under investigation. Finally our results encourage inhibiting ABCA3, such as with indomethacin, in order to overcome drug resistance in AML treated with GO-IC. Figure 1 Figure 1. Disclosures Thomas: Pfizer: Consultancy.

Association of losartan use with outcomes in metastatic pancreatic cancer patients treated with chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16738-e16738
Author(s):  
Jessica Allen ◽  
Kathan Mehta ◽  
Shrikant Anant ◽  
Prasad Dandawate ◽  
Anwaar Saeed ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Metastatic Cancer ◽  
Statistical Significance ◽  
Objective Response ◽  
Locally Advanced ◽  
Small Sample ◽  
Ductal Adenocarcinoma ◽  
Control Group ◽  
100Mg Dose ◽  
Significant Difference

e16738 Background: A phase II trial has shown improved efficacy of neoadjuvant therapy when combined with losartan (by remodeling desmoplasia) in locally advanced pancreatic ductal adenocarcinoma (PDA). However, role of losartan is unknown in metastatic PDA. We examined the relationship between the use of the angiotensin II receptor antagonist, losartan, at time of diagnosis with clinical outcomes in metastatic PDA pts that received chemo. Methods: We retrospectively evaluated 114 metastatic PDA pts treated at our center between Jan 2000 and Nov 2019. We compared OS, PFS, objective response rate (ORR), and disease control rate (DCR) between pts using losartan at time of cancer diagnosis and a control group of pts not on losartan. A subanalysis was performed based on losartan dose: 100mg dose versus control pts. and based on chemo: FOLFIRINOX or gemcitabine+abraxane. Results: Table shows baseline demographics. No significant difference was found in OS [p = 0.455] or PFS [p = 0.919] in pts on losartan (median 274d, 83d) vs control (median 279d, 111d) [p = 0.466]. No significant difference was found in ORR [p = 0.621] or in DCR [p = 0.497]. No significant difference was found in OS [p = 0.771] or PFS [p = 0.064] in losartan pts (median 347d, 350d) vs control (median 333d, 101d) treated with FOLFIRINOX. No significant difference was found in OS [p = 0.916] or PFS [p = 0.341] in losartan (median 312d, 69d) vs control (median 221d, 136d) [p = 0.916] treated with gemcitabine+abraxane. No significant difference was found in OS [p = 0.727] or PFS [p = 0.790] in 100mg losartan pts (median 261d, 84d) vs control (median 279d, 111d). Conclusions: Pts on losartan at time of diagnosis had no significant difference in OS, PFS, ORR, DCR than control pts. However, a subanalysis of pts treated with FOLFIRINOX revealed a longer PFS with losartan than control but did not meet statistical significance, likely due to small sample size. To confirm if the benefit of losartan + FOLFIRINOX seen in neoadjuvant setting for locally advanced cancer also applies to metastatic cancer, our findings need to be validated in a larger cohort. [Table: see text]

scholarly journals Perioperative, Single-Surgeon Experience in Cerebrovascular Bypass Procedures at Academic Medical Center and Community Hospital

2018 ◽  
Vol 05 (03) ◽  
pp. 173-176
Author(s):  
Kathleen W. Nissman ◽  
Ali R. Zomorodi ◽  
Dhanesh K. Gupta ◽  
Ishwori Dhakal ◽  
Yi-Ju Li ◽  
...  
Keyword(s):  
Community Hospital ◽  
Small Sample Size ◽  
Medical Center ◽  
Academic Medical Center ◽  
Small Sample ◽  
Neurosurgical Procedures ◽  
Academic Medical ◽  
Tertiary Center ◽  
Significant Difference ◽  
Surgeon Experience

Abstract Background Little evidence exists for superiority of neurosurgical outcomes from care subspecialization. Outcomes of a single neurosurgeon after complex vascular neurosurgery in an academic medical center were compared against those in a community hospital. Methods In this retrospective analysis of extracranial-intracranial vascular bypass operations performed between July 1, 2013 and February 1, 2015, cases were identified by cross-referencing the electronic medical record with the surgeon's own records. Pre-, intra-, and postoperative variables were abstracted from cases performed at a tertiary center and a community hospital. Dichotomous postoperative data recorded included extubation in the operating room (OR), readmission, and survival to discharge, and length of stay was also analyzed. Due to small sample size and low readmission rate, Firth's penalized likelihood tests were incorporated in the logistic regression model for parameter estimation and testing. Results A total of 28 hemispheres in 26 patients were included: 18 hemispheres in 16 patients at the tertiary center and 10 hemispheres in 9 patients at the community hospital. Differences were found in operative time (tertiary mean: 7.21 + 2.5 hours, community mean: 5.19 + 0.9 hours, p = 0.0074) and readmission to the tertiary center (p = 0.078). However, significant difference was observed only for anesthetic type (more likely to include remifentanil and propofol at the tertiary center, p = 0.0104). Conclusion Subspecialty care alone may be insufficient to enhance outcome after complex neurosurgical procedures.

scholarly journals The Effectiveness of Using Big Book Media on Early Reading Skills in 5-6 Years Old

2021 ◽  
Vol 7 (2) ◽  
pp. 157-166
Author(s):  
Winda Oktaviana ◽  
Jhoni Warmansyah ◽  
Winda Trimelia Utami
Keyword(s):  
Reading Skills ◽  
Small Sample Size ◽  
Early Reading ◽  
Sampling Technique ◽  
Small Sample ◽  
T Test ◽  
Average Score ◽  
Control Group ◽  
Early Reading Skills ◽  
Significant Difference

Purpose – This study aims to determine the effectiveness of using Big Book media on early reading skills in children aged 5-6 years old.Design/methods/approach – This study used a quantitative approach which was carried out in an experimental method with a pre-post-test design. The sampling technique uses a simple random technique with 30 children. Data collection technique is by means of tests. The analysis technique for testing the hypothesis uses the difference test (t-test).Findings – The results showed that children in the experimental group who used Big Book media had a higher average score when compared to children in the control group who used magazine media. Based on the t-test calculation, findings indicate that there was a significant difference between the two groups. Thus, it can be concluded that the Big Book media is effective on early reading skills in children aged 5-6 years old.Research implications/limitations – This study was limited to one location, Mutiara Al-Madani Kindergarten, Jambi Indonesia, and with a small sample size, so the generalizability of the findings was also limited. It is necessary for future researchers to conduct studies with a wider scope and a more diverse population.Practical implications – The use of Big Book media can be an alternative learning media that can attract children's interests and can actively involve children in gaining rich literacy experiences in improving early reading skills.Originality/value – This study contributes to understanding of teacher's reference material in using learning media for early reading skills in children aged 5-6 years old. Paper type Research paper

Abstract WP124: Ataste 2: Assessment of Anti-Hypertensive Treatment and Acute Stroke Treatment Efficiency 2

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Brian Sorace ◽  
Brett Meyer ◽  
Dawn Meyer ◽  
Kunal Agrawal
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Blood Pressures ◽  
Pre Treatment ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Cerebral Reperfusion ◽  
Iv Tpa

Introduction: Treatment of acute ischemic stroke (AIS) with tPA must be rapid for timely cerebral reperfusion. Anti-hypertensive (AHT) medication may be required to lower blood pressures prior to tPA. Optimal AHT use and its impact on tPA times is unclear. We examined treatment with IV bolus only (IVB), IV continuous infusion only (IVCI), or both bolus and infusion (BBI) AHTs on door-to-needle time (DTN) in AIS patients eligible for IV tPA. We hypothesized that 1) DTN would be significantly longer in patients requiring IV AHT before treatment and 2) DTN would be significantly lower in patients treated with IVCI compared to IVB or BBI. Methods: We analyzed all stroke codes who received IV tPA at our comprehensive stroke center from July 1, 2008 to June 30, 2019. Subjects were grouped by those that required IV AHT prior to IV tPA (med+tPA) and those that did not (no-med+tPA). The three medication groups were IVB, IVCI, or BBI. Variables examined were initial and immediate pre-treatment blood pressures, NIHSS, mRS, and initial blood glucose. The primary outcome was DTN between groups. Results: Overall, 288 patients were included in the analysis. Approximately 12% (n=35) of patients required IV AHTs before tPA. There was a significant difference between the med+tPA and no-med+tPA groups in 1) median NIHSS (12.5, 10; p=0.040) and initial mean glucose (142, 122.5; p&lt;0.001), respectively. DTN was significantly longer in med+tPA vs no-med+tPA mean (77.5 min, 56.4 min; p=0.036). Systolic blood pressures (SBP) were significantly higher in patients requiring AHT treatment (initial SBP: med+tPA 175.5 mmHg, no-med-tPA 144.1 mmHg, p=0.001). There was no difference in DTN between IVB, IVCI, or BBI groups when compared to the no-med+tPA group (p=0.351, 1.000, & 0.997). There was no difference in the 90-day mRS between IVB, IVCI, or BBI compared to control (p=0.236, 0.339, & 0.326). Conclusions: Fewer patients required AHT than expected suggesting lower rates of baseline hypertension in our region. Type of AHT agent used did not significantly impact DTN. This may be due to the small sample size of patients receiving blood pressure medication prior to tPA in this study. Further prospective studies are needed to examine the optimal AHT treatment modality on DTN.

scholarly journals Effect of Echium Amoenum on the Anxiety of College Students

2020 ◽  
Vol 10 (1) ◽  
pp. 46-55
Author(s):  
Somayeh Soltani Nejad ◽  
◽  
Maryam Zeighami ◽  
Ashraf Beirami ◽  
Ahmadali Amirifar ◽  
...  
Keyword(s):  
College Students ◽  
Nursing Students ◽  
Sample Size ◽  
Small Sample Size ◽  
Intervention Group ◽  
Small Sample ◽  
T Test ◽  
Control Group ◽  
Significant Difference ◽  
Echium Amoenum

Objective: Humans always have faced with the phenomenon of anxiety and have tried to find solutions to overcome this problem by various methods. The aim of this study was to determine the effect of echium amoenum on the anxiety of college students. Methods: This is a clinical trial study. Participants were 40 nursing students in Kerman, Iran who were randomly assigned into two groups of intervention (n=20) and control (n=20). The data collection tools were a demographic form and Cattle’s anxiety questionnaire. First, the baseline assessment was conducted in both groups. Then, the intervention group received 1 g echium amoenum powder in 250cc boiling water daily. After a month, both groups were assessed again. Data analysis was performed in SPSS v.20 software using descriptive and inferential statistics (mean, standard deviation, chi-square test, paired t-test, independent t-test, Mann-Witney U test). Results: At baseline, there was no significant difference between the two groups. After consumption of echium amoenum, the overall anxiety score decreased from 40.4±6.31 to 38.65±3.39 in the intervention group and increased from 39.7±9.29 to 41.75±9.91 in the control group; however, these differences were not statistically significant. Conclusion: Echium amoenum could reduce anxiety in the students, but its effect was not significant maybe due to the short duration of its use or small sample size. Hence, further studies with a larger sample size are recommended.

scholarly journals EVALUATION OF TONGUE FORCE USING PIEZOELECTRIC SENSOR IN TONGUE THRUSTING PATIENTS

2021 ◽  
Vol 9 (10) ◽  
pp. 839-842
Author(s):  
K.S. Premkumar ◽  
◽  
N. Kurunji Kumaran ◽  
K. Rajasigamani MDS ◽  
V. Bhaskar MDS ◽  
...  
Keyword(s):  
Sample Size ◽  
Constant Pressure ◽  
Small Sample Size ◽  
Piezoelectric Sensor ◽  
Small Sample ◽  
Control Group ◽  
Dental Arch ◽  
Tooth Position ◽  
Significant Difference ◽  
Stable Maintenance

Tooth position and the form of the dental arch are subject to constant pressure from the circum-oral muscles and the tongue. Stable maintenance of the position of the teeth and the form of the dental arch is thought to depend on the balance of these pressures. Literature regarding the association of tongue force and the malocclusion remains controversial. Hence the present study aimed to measure the tongue force among the tongue thrusting patients using piezoelectric sensor and to compare with the control group. The results of the present study showed that there was no statistical significant difference between the two groups. This could be because of small sample size, which leads for future scope to increase in the sample size.

scholarly journals Vertebroplasty for Treatment of Osteolytic Metastases at C2 Using an Anterolateral Approach

2013 ◽  
Vol 4;16 (4;7) ◽  
pp. E427-E435
Author(s):  
Gang Sun
Keyword(s):  
Small Sample Size ◽  
Medical Center ◽  
Therapy Group ◽  
Interventional Therapy ◽  
Small Sample ◽  
Anterolateral Approach ◽  
Clinical Effects ◽  
Significant Difference ◽  
Osteolytic Metastases ◽  
The Mean

Background: The clinical management of osteolytic metastases involving C2 is unique, because it is challenging to approach these lesions. Symptoms may vary from local pain to progressive neurological deficit. Surgery or radiotherapy have been the treatments of choice for several years; however, surgery may not be an option for patients with multiple metastases and poor general medical status, and radiotherapy carries the risk of vertebral collapse and consequent neural compression due to delayed bone reconstruction. Through different approaches, vertebroplasty has been introduced into clinical practice as an alternative to traditional surgical and radiotherapy treatments of osteolytic metastases at C2. Objective: This study aimed to evaluate the safety and efficacy of vertebroplasty with an anterolateral approach for osteolytic metastases at C2 under fluoroscopic guidance. Study Design: Vertebroplasty in 13 patients with osteolytic metastases at C2 and its clinical effects were evaluated. Setting: This study was conducted in an interventional therapy group at a medical center in a major Chinese city. Methods: Thirteen consecutive patients were treated with vertebroplasty via an anterolateral approach. The researchers followed up with the patients for 3 to 12 months, with an average of 9.2 months. The clinical effects were evaluated with the visual analog scale (VAS) preoperatively and at 3 days, one month, 3 months, 6 months, and 12 months post-operatively. Results: Thirteen consecutive patients were successfully treated with a satisfying resolution of painful symptoms. Extraosseous cement leakages were found in 5 cases without any clinical complications. VAS scores decreased from 7.6 ± 0.9 pre-operatively to 2.1 ± 1.9 by the 3-day post-operative time point, and were 1.8 ± 1.7 at one month, 1.7 ± 1.8 at 3 months, 0.9 ± 0.8 at 6 months, and 0.6 ± 0.5 at 12 months after the procedure. There was a significant difference between the mean pre-operative baseline score and the mean score at all of the post-operative follow-up points (P < 0.001). Limitations: This was an observational study with a relatively small sample size. Conclusions: Vertebroplasty via an anterolateral approach is an effective technique to treat osteolytic metastases involving C2. It is a valuable, minimally invasive, and efficient method that allows quick and lasting resolution of painful symptoms. Key words: Vertebroplasty, C2, anterolateral approach, osteolytic metastasis, pain

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