BACKGROUNDVertebral pedicular metastasis in lung cancer patients are common. This is a preliminary study on methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastasis of lung cancer.

METHODSPercutaneous pediculoplasty was performed in 5 lung cancer patients with osteolytic metastasis in 7 vertebral pedicles, 2 cases occurred in thoracic vertebral pedicles and 3 cases occurred in lumbar vertebral pedicles, 2 cases had two loci involved. Under Multislice helical CT guidance, 2.5-5mL of polymethylmethacrylate mixture (ratio of polymer, moner, ultrafluid iodinated oil was 20g:10mL:3mL) had been injected into pathologic pedicles step by step after successful puncture using 13G needle. All cases had been followed-up in 2-5 months.

RESULTSAll cases had been successfully punctured. Pain relieved in all 4 cases to some extent after percutaneous pediculoplasty. Two cases had bone-cement leakage, 1 case with leakage into intervertebral foramen which led to nerve radicular pain, the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips, and another 1 case with minor leakage into vertebral canal but without clinical symptoms. No spondyloptosis occurred in all cases after follow-up.

CONCLUSIONSCT-guided percutaneous pediculoplasty is a minimal injured, effective and safe method for osteolytic vertebral pedicular metastasis of lung cancer.