Background: Percutaneous 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.
Objectives: To 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 Design: Single-center retrospective observational study.
Setting: An interventional pain management practice, a medical center, major metropolitan city,
China.
Methods: Single-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.
Results: Nine 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.
Limitations: This study is limited by its sample size.
Conclusions: PV and PP via the transpedicular approach for infiltrated vertebral bodies and
infiltrated pedicles of metastatic tumors may be considered a valid therapeutic option.
Key words: Percutaneous pediculoplasty, percutaneous vertebroplasty, lytic pedicular lesions,
bone cement
A Single-Center Retrospective Observational Study Evaluating the Favorable Predictive Factors for the Disease Control Time of Treatment with Tocilizumab in Patients of Rheumatoid Arthritis
