title: Real-time CT fluoroscopy (CTF)-guided vertebroplasty in osteoporotic spine fractures.
abstract: The purpose of this study was to evaluate the clinical feasibility, benefits, and limitations of CT fluoroscopy (CTF)-guided percutaneous vertebroplasty (PVP). PVP under the guidance of CTF without additional guidance by conventional C-arm fluoroscopy was performed in a total of 29 vertebral bodies in 21 patients with vertebral compression fractures. While monitoring sectional CTF images, the needle was advanced from the skin to the target vertebra. Contrast media and polymethylmethacrylate (PMMA) were injected into the target vertebra with careful monitoring of their distribution. After the procedure, an evaluation was conducted to determine whether extraosseous leakage of PMMA occurred and whether sufficient filling of PMMA had been achieved. Needle placement into the target vertebra was easily achieved with both the transpedicular and posterolateral approaches. Injection of PMMA and venous leakage of contrast media were carefully monitored in all patients, and early detection of PMMA leaking was achieved in 5 patients. Extraosseous leakage that had not been detected during the procedure was not found upon postoperative evaluation. Pain scales were significantly decreased after the procedure, and no obvious complications occurred following the procedure. CTF-guided PVP without the combined use of C- arm fluoroscopy was feasible and showed definite benefits. We believe that, in spite of some limitations, CTF-guided PVP provides an alternative technique appropriate in certain situations.
authors.affiliation: Department of Diagnostic Radiology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyung Suk
authors.initials: KS
authors.lastname: Park
authors.forename: Seung
authors.initials: S
authors.lastname: Yi
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Shin
authors.forename: Do Heum
authors.initials: DH
authors.lastname: Yoon
authors.forename: Keung Nyun
authors.initials: KN
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications*; D019904:Polymethyl Methacrylate; D011829:Radiation Dosage; D016103:Spinal Fractures / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D019904:Polymethyl Methacrylate