title: Unilateral transpedicular percutaneous vertebroplasty: initial experience.
abstract: OBJECTIVE
  To compare the radiographic and clinical outcomes of a unipediculate approach with those of standard bipediculate vertebroplasty.
  
  
  METHODS
  Retrospective review of percutaneous vertebroplasties yielded 18 vertebrae in 17 patients that were treated with a standard bipediculate approach and 57 vertebrae in 32 patients that were treated with a modified unipediculate approach. Anteroposterior radiographs obtained after the procedure were viewed to calculate the percentage of cement opacification in both vertebral halves, and mean values were compared between uni- and bipediculate approaches by using a two-tailed Student t test. Clinical outcomes, including pain relief and change in pain medication requirements, were compared in the two groups by using the chi(2) or Fisher exact test.
  
  
  RESULTS
  With the unipediculate approach, filling across the midline was achieved in 55 (96%) of 57 injections. Mean opacification of vertebral body halves was 83% +/- 19 (SD) and 77% +/- 16 for the bipediculate and unipediculate approaches, respectively (P =.19). Among patients with available follow-up data, 16 (94%) of 17 patients who underwent the bipediculate procedure and 28 (88%) of 32 patients who underwent the unipediculate procedure achieved adequate pain relief (P =.65) with mean decreases in pain severity of 7.3 +/- 3.1 and 6.6 +/- 2.9, respectively.
  
  
  CONCLUSIONS
  Use of a unipediculate approach in percutaneous vertebroplasty allows filling of both vertebral halves from a single puncture site with no statistically significant difference in clinical outcome from that of bipediculate vertebroplasty.
authors.affiliation: Department of Radiology, University of Virginia Health Services, Box 800170, Charlottesville, VA 22908, USA.
authors.forename: Ann K
authors.initials: AK
authors.lastname: Kim
authors.forename: Mary E
authors.initials: ME
authors.lastname: Jensen
authors.forename: Jacques E
authors.initials: JE
authors.lastname: Dion
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Schweickert
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kaufmann
authors.forename: David F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D000368:Aged; D001416:Back Pain / Q000209:etiology; D001843:Bone Cements / Q000009:adverse effects*; D002484:Cementation / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D005598:Fractures, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000008:administration & dosage*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate