Purpose <p>To describe the surgical technique of vesselplasty for painful, destructive lesions of the C2 vertebral body through an anterior mini-incision cervical approach, and to report the preliminary clinical outcomes. </p> Methods <p>All patients underwent the anterior mini-incision vesselplasty using bone filling container for C2 metastasis by the same surgical team. The study comprehensively evaluated the entire treatment process, including the preoperative assessment, the surgical technique, and the clinical outcomes. Follow-up assessments were conducted at 1 day, 3 months, 6 months, and 1 year postoperatively. </p> Results <p>The procedures were successfully completed in nine consecutive patients (mean age 56.3 ± 15.0 years) with no procedure-related complications. The median blood loss was 10 ml (IQR 5, 10). The average cement volume was 1.2 ± 0.2 ml, which was injected through a 1.0 ± 0.2 cm incision. The mean operative duration was 35.0 ± 7.4 minutes. The median VAS score decreased from 9 (IQR, 9 to 10) preoperatively to 1 (IQR, 1 to 2) immediately after surgery (P &lt; 0.0125). The median NDI score was significantly improved from 61% (IQR, 55% to 67%) preoperatively to 33% (IQR, 32% to 35%) at the 1-year follow-up (P &lt; 0.0125). All patients maintained an ASIA grade of E throughout the median follow-up of 12 months, indicating no neurological deterioration.</p> Conclusion <p>The preliminary results of this case series suggest that the anterior mini-incision vesselplasty using bone filling container may be a feasible palliative option for painful C2 osteolytic metastases. However, larger comparative studies are needed to confirm these findings.</p>