We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of patients with severe fibrous dysplasia
of the spine with multiple cervical lesions and C2–C3 pathologic fractures that may not be a good surgical candidate. Polyostotic
fibrous dysplasia involvement of the cervical spine is rare. Review of literature indicates only few reported cases of surgical
management with one case of mortality indicating increased risks associated with surgical intervention. While PVP is commonly
used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization
for fibrous dysplasia has not been reported. A 35-year-old man with McCune–Albright syndrome and severe polyostotic fibrous
dysplasia of C2 and C3 vertebrae presented with severe neck pain, radiculopathy, quadriparesis and myelopathy. The lesion
had pathologic fractures, and there was an os odontoideum with cervical cord atrophy at the C1 level. After discussing need
for aggressive surgical management and potential complications, we offered PVP due to surgical risks involved. PVP was performed
with a posterolateral transpedicular approach without complication. The patient had remarkable improvement in clinical relief
of neck pain and improvement of myelopathic symptoms at 1-year follow-up. We present a case that illustrates a potential use
of PVP in the management of a patient with symptomatic spinal fibrous dysplasia with associated pathologic fractures who was
poor surgical candidate.
Keywords Percutaneous vertebroplasty - Polyostotic - Fibrous dysplasia