Safety of fluoroscopy guided percutaneous access to the thoracic spine

Clamp, Jonathan A.; Bayley, Edward; Ebrahimi, F. V.; Quraishi, Nasir A.; Boszczyk, Bronek M.

doi:10.1007/s00586-012-2201-7

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…PVP is both relatively simple and less traumatic procedure. Many techniques have been developed for simpler and safer procedures 121314. Unilateral pedicular approach and bilateral pedicular approach are both used for PVP 1415.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Tan

Zhang

Mao

et al. 2016

IJOO

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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.

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Section: Discussionmentioning

confidence: 99%

Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Tan

Zhang

Mao

et al. 2016

IJOO

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“…Jamshidi needles (DePuy-Synthes, West Chester, Pennsylvania, United States) of 3-mm diameter were inserted into the two most cephalad vertebral bodies via the transcostovertebral route ( Fig. 2 ), 34 after which a minimum of 4 mL polymethyl methacrylate bone cement (Vertecem V, DePuy-Synthes, West Chester, Pennsylvania, United States) was injected to each vertebra. We inserted the screws through the Jamshidi tracts into the soft cement ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Staged Correction of Severe Thoracic Kyphosis in Patients with Multilevel Osteoporotic Vertebral Compression Fractures

Behrbalk

Uri

Folman

et al. 2015

Global Spine Journal

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Study Design Technical report. Objective Multilevel osteoporotic vertebral compression fractures may lead to considerable thoracic deformity and sagittal imbalance, which may necessitate surgical intervention. Correction of advanced thoracic kyphosis in patients with severe osteoporosis remains challenging, with a high rate of failure. This study describes a surgical technique of staged vertebral augmentation with osteotomies for the treatment of advanced thoracic kyphosis in patients with osteoporotic multilevel vertebral compression fractures. Methods Five patients (average age 62 ± 6 years) with multilevel osteoporotic vertebral compression fractures and severe symptomatic thoracic kyphosis underwent staged vertebral augmentation and surgical correction of their sagittal deformity. Clinical and radiographic outcomes were assessed retrospectively at a mean postoperative follow-up of 34 months. Results Patients' self-reported back pain decreased from 7.2 ± 0.8 to 3.0 ± 0.7 (0 to 10 numerical scale; p < 0.001). Patients' back-related disability decreased from 60 ± 10% to 29 ± 10% (0 to 100% Oswestry Disability Index; p < 0.001). Thoracic kyphosis was corrected from 89 ± 5 degrees to 40 ± 4 degrees (p < 0.001), and the sagittal vertical axis was corrected from 112 ± 83 mm to 38 ± 23 mm (p = 0.058). One patient had cement leakage without subsequent neurologic deficit. Decreased blood pressure was observed in another patient during the cement injection. No correction loss, hardware failure, or neurologic deficiency was seen in the other patients. Conclusion The surgical technique described here, despite its complexity, may offer a safe and effective method for the treatment of advanced thoracic kyphosis in patients with osteoporotic multilevel vertebral compression fractures.

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Spine Biopsy

Cianfoni¹,

Pellicanò²

2017

Vertebral Lesions

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Safety of fluoroscopy guided percutaneous access to the thoracic spine

Cited by 7 publications

References 14 publications

Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Staged Correction of Severe Thoracic Kyphosis in Patients with Multilevel Osteoporotic Vertebral Compression Fractures

Spine Biopsy

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