La radiologia medica

, Volume 113, Issue 1, pp 114–133 | Cite as

CT-guided percutaneous vertebroplasty: personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases

  • R. Caudana
  • L. Renzi Brivio
  • L. Ventura
  • E. Aitini
  • U. Rozzanigo
  • G. Barai
Musculoskeletal Radiology Radiologia Muscoloscheletrica
First Online:
Received:
Accepted:

Abstract

Purpose

This study was performed to evaluate the results and complications of percutaneous vertebroplasty (PVP) performed under CT guidance.

Materials and methods

We treated 106 patients (182 PVP): 67 for osteoporotic vertebral compression fracture, and 39 for osteolytic metastases. The first 78 patients were treated using computed tomography (CT) combined with conventional fluoroscopy as an imaging guide (135 PVP). In 28 patients, the procedure was performed with multislice CT fluoroscopy (47 PVP).

Results

Partial or complete pain relief was obtained in 98% of patients within 24 h from the treatment; significant results were also obtained with regard to improvement in functional mobility and reduction of analgesic use. CT allowed the detection of cement leakage in 43.9%. Severe complications were one case of pneumothorax and two cases of symptomatic cement leakage. Mild complications included two cases of cement pulmonary embolism. During the follow-up, eight osteoporotic patients presented a new vertebral fracture, and new vertebral metastases appeared in two oncological patients.

Conclusions

Our personal experience confirms the efficacy of PVP treatment for both osteoporotic and oncological patients. The use of CT guidance reduces the risk of complications in comparison with conventional fluoroscopy alone, as well as facilitates the detection of small cement leakages.

Keywords

Spine vertebroplasty Spine fractures Spine CT Spine secondary neoplasms Osteoporosis 

Vertebroplastica percutanea (VPP) TC-assistita: esperienza personale nel trattamento delle fratture osteoporotiche e delle metastasi dorso-lombari

Riassunto

Obiettivo

Valutazione dei risultati e delle complicanze della vertebroplastica percutanea (VPP) TC-guidata.

Materiali e metodi

Sono stati trattati 106 pazienti (182 VPP): 67 per crollo osteoporotico, 39 per lesioni neoplastiche. Nei primi 78 pazienti la guida TC è stata associata alla radio-fluoroscopia tradizionale (135 VPP). In 28 pazienti si è utilizzata solo TC-scopia con apparecchiatura multistrato (47 VPP).

Risultati

Nel 98% dei pazienti si è rilevata riduzione/scomparsa del dolore entro 24 ore dal trattamento; i risultati sono stati significativi anche per la riduzione della terapia farmacologica ed il miglioramento della autonomia motoria. La TC ha riscontrato fughe extra-vertebrali di cemento nel 43,9%. Le complicanze gravi sono state 1 pneumotorace e 2 fughe di cemento sintomatiche; le complicanze lievi sono state 2 embolie polmonari di cemento. Nel follow-up 8 pazienti osteoporotici hanno presentato nuove fratture, mentre 2 pazienti oncologici hanno presentato altre metastasi vertebrali.

Conclusioni

L’esperienza personale conferma l’efficacia del trattamento di VPP sia nei pazienti osteoporotici che in quelli neoplastici. L’impiego della guida TC riduce i rischi di complicanze rispetto alla sola guida fluoroscopica convenzionale e rende più agevole il riconoscimento di piccole fughe extravertebrali di cemento.

Parole chiave

Vertebroplastica Fratture vertebrali TC vertebrale Metastasi vertebrali Osteoporosi 
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Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • R. Caudana
    • 1
  • L. Renzi Brivio
    • 2
  • L. Ventura
    • 3
  • E. Aitini
    • 4
  • U. Rozzanigo
    • 1
  • G. Barai
    • 5
  1. 1.Unità Operative di Diagnostica per ImmaginiAzienda Ospedaliera Carlo PomaMantovaItaly
  2. 2.Ortopedia e TraumatologiaAzienda Ospedaliera Carlo PomaMantovaItaly
  3. 3.Medicina Generale (Sezione di malattie osteometaboliche)Azienda Ospedaliera Carlo PomaMantovaItaly
  4. 4.OncologiaAzienda Ospedaliera Carlo PomaMantovaItaly
  5. 5.Servizio di Fisica SanitariaAzienda Ospedaliera Carlo PomaMantovaItaly

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