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Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Indian Journal of Orthopaedics volume 50, pages 622–628 (2016)Cite this article

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 fuoroscopic 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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Affiliations

  1. Department of Interventional Radiology, The Affliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province, 212001, P. R. China

    Zhongbao Tan,  Zhenhai Di, Xuequn Mao, Jian Zhang, Rong Zou & Qingqing Wang

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  1. Zhongbao Tan
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  2. Zhenhai Di
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  3. Xuequn Mao
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  4. Jian Zhang
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  6. Qingqing Wang
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Correspondence to Zhenhai Di.

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Tan, Z., Di, Z., Mao, X. et al. Percutaneous vertebroplasty guided by preoperative computed tomography measurements. IJOO 50, 622–628 (2016). https://doi.org/10.4103/0019-5413.193477

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  • DOI: https://doi.org/10.4103/0019-5413.193477

Key words

  • Computed tomography image
  • three-dimensional localization
  • percutaneous vertebroplasty
  • unilateral pedicular approach

MeSH terms

  • Spinal injury
  • CAT scan
  • bone cements
  • back pain
  • vertebrae