title: Minimally invasive vertebroplasty managed by a two C-arm fluoroscopic technique.
abstract: One C-arm fluoroscope is widely considered to be sufficient for effectively monitoring minimally invasive vertebroplasty. However, rotating the C-arm fluoroscope for different radiographic views of the spine can be time-consuming, causing delay in detecting cement leakage. We retrospectively reviewed the results of minimally invasive vertebroplasty utilizing two C-arm fluoroscopes in the treatment of osteoporotic vertebral fractures. Forty-two patients (50 vertebrae) were treated with minimally invasive vertebroplasty under the guidance of two C-arm fluoroscopes. The mean operation time, patient satisfaction rate and the incidences of cement leakage or infection were used to evaluate the feasibility and efficacy of the two C-arm fluoroscopic technique in performing minimally invasive vertebroplasty. The mean follow-up duration was 17.4 months (range 6 approximately 36). The mean operation time was 37+/-14 minutes. Thirty patients (71%) were very satisfied or satisfied with the procedure. Cement leakages were identified in nine patients (nine vertebrae, 18%). Only one vertebra had a posterior leakage into spinal canal, which did not cause neurologic deficits. No wound infection was observed. This study indicates that the two C-arm fluoroscopic technique provides simultaneous antero-posterior and lateral radiographic views, and therefore may reduce the operation time. No symptomatic cement leakage or wound infection was noted in this investigation. Moreover, no additional staff is needed to rotate the C-arm for fluoroscopy. The proposed technique has been shown to be effective and useful for performing minimally invasive vertebroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Chia-Yi, College of Medicine, Chang Gung University, Taipei, Taiwan.
authors.forename: Yen-Yao
authors.initials: YY
authors.lastname: Li
authors.forename: Robert Wen-Wei
authors.initials: RW
authors.lastname: Hsu
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Cheng
authors.forename: Tsung-Jen
authors.initials: TJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D010024:Osteoporosis / Q000150:complications* / Q000503:physiopathology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation* / Q000379:methods