Percutaneous vertebroplasty guided by preoperative computed tomography measurements

Autor: Zhen-Hai Di, Qingqing Wang, Rong Zou, Xue-Qun Mao, Zhongbao Tan, Jian Zhang
Rok vydání: 2016
Předmět:
mesh:bone cements
medicine.medical_specialty
medicine.medical_treatment
Technical success
back pain
percutaneous vertebroplasty
Computed tomography
macromolecular substances
mesh:back pain
mesh:CAT scan
unilateral pedicular approach
mesh:Spinal injury
Percutaneous vertebroplasty
03 medical and health sciences
0302 clinical medicine
lcsh:Orthopedic surgery
CAT scan
vertebrae
medicine
Back pain
Orthopedics and Sports Medicine
030212 general & internal medicine
bone cements
medicine.diagnostic_test
business.industry
Significant difference
mesh:vertebrae
technology
industry
and agriculture
three-dimensional localization
Sagittal plane
Vertebra
lcsh:RD701-811
medicine.anatomical_structure
Orthopedic surgery
unilateral pedicular approach MeSH terms: Spinal injury
Original Article
Radiology
medicine.symptom
business
030217 neurology & neurosurgery
Computed tomography image
Zdroj: Indian Journal of Orthopaedics
Indian Journal of Orthopaedics, Vol 50, Iss 6, Pp 622-628 (2016)
ISSN: 1998-3727
0019-5413
DOI: 10.4103/0019-5413.193477
Popis: 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.
Databáze: OpenAIRE
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