Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Abstract

Background:Percutaneous vertebroplasty (PVP) is now widely performed to treat painful vertebral compression fractures. Previous researches have reported numerous advantages. However, it rarely reported that how to determine the feasibility of the unilateral or bilateral approach and how to decide the puncture angle, the skin insertion site before the procedure. The aim of this study was to discuss the feasibility of PVP using unilateral pedicular approach by the three-dimensional positioning of computed tomography (CT) image.Materials and Methods:Under fluoroscopic guidance, 108 patients with 115 diseased vertebral bodies underwent PVP. The study was divided in two groups. Group A, fifty patients with 52 vertebrae received PVP without using preoperative CT measurements and puncture simulation. Group B, 58 patients with 63 vertebrae received PVP using preoperative CT measurements and puncture simulation. The skin needle entry point and puncture angle of the transverse plane and sagittal plane were determined by the software of PACS on preoperative CT image. The choice of unilateral or bilateral pedicular approach was decided based on the CT image before the procedure. PVP was carried out according to the measurement result above. The average time for a single vertebra operation, the success rate of single puncture and complications was evaluated and compared between Group A and Group B.Results:In Group A, technical success of unilateral PVP was 63.5% (33/52 vertebrae), and 92% (58/63 vertebrae) in Group B. The average time of operation in Groups A and B were (37.5 ± 5.5) and (28.5 ± 5.5) min, respectively. There was a significant difference in the time of single-vertebra operation and the success rates of unilateral PVP between Groups A and B. No serious complications developed during the followup period.Conclusions:The CT three-dimensional positioning measurement for PVP can increase the success rate of unilateral PVP.

“Targeted Percutaneous Vertebroplasty” Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture

“…PVP assisted by preoperative computed tomography (CT) digital design is increasing recently. Some researchers have reported that an improved PVP performed with preoperative CT design can boost the success rate of pedicle puncture, 12 but weak clinical practicability limits its further more application. Currently, a kind of economic, simple, and accurate technique for percutaneous puncture is urgently needed.…”

Analysis of the Causes on Poor Clinical Efficacy of Kyphoplasty Performed in Unilateral Transpedicular Puncture for the Treatment of Senile Osteoporotic Vertebral Compression Fractures

“…But it is necessary to repeat the operation twice in bilateral transpedicular puncture, use two sets of operating instruments, and increase operation time and radiation exposure time, which also increase patients’ economic burden. Therefore, more and more scholars tend to use unilateral transpedicular puncture approach 9–11 . However, in clinical use of unilateral transpedicular percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures, we found that some patients had no significant relief of postoperative pain symptoms or still had residual partial pain.…”