title: Percutaneous vertebroplasty with the rotational fluoroscopy imaging technique.
abstract: OBJECTIVE
  To evaluate the feasibility of the rotational angiography unit (RAU) as a single technique to guide percutaneous vertebroplasty (PVP).
  
  
  METHODS
  Twenty-five consecutive patients (35 vertebral bodies, 20 lumbar and 15 thoracic) were treated using RA fluoroscopy. Using a state-of-the-art flat-panel angiographer (Artis zee, Siemens, Erlangen, Germany), rotational acquisitions were obtained in all patients for immediate post-procedure 2D/3D reconstructions. Pre- and postoperative back pain was assessed with the visual analog scale (VAS). Fluoroscopy time, patient radiation dose exposure, technical success, mean procedure time, mean number of rotational acquisitions and procedural complications were recorded. All features were compared with a historical cohort of patients (N = 25) who underwent PVP under CT and mobile C-arm fluoroscopy guidance.
  
  
  RESULTS
  In all cases, safe and accurate control of the needle insertion and bone-cement injection was successfully obtained with high-quality fluoroscopy images. One cement leakage was detected in the RAU group, and two leakages were detected in the CT and C-arm fluoroscopy group. Technical features were significantly different between the two groups (RAU vs. CT): mean procedure time: 38.2 min vs. 60.2 min (p = 0.02); median fluoroscopy time: 14.58 and 4.58 min (p = 0.02); median number of rotational acquisitions: 5 vs. 10 (p = 0.02); mean patient dose: 6 ± 1.3 mSv vs. 23 ± 1.3 mSv (p = 0.02). There were minor complications (pain, small hematoma) in two patients (8%) in the study group and three cases (12%) in the control group.
  
  
  CONCLUSIONS
  RAU guidance is an effective and safe technique for performing PVP because it reduces the procedural time and radiation exposure.
authors.affiliation: Vascular and Interventional Unit, Department of Radiological Sciences, "Sapienza" University of Rome, 324 Viale Regina Elena, Rome, 00161, Italy, alessandro.cannavale@hotmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cannavale
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Salvatori
authors.forename: Andrea
authors.initials: A
authors.lastname: Wlderk
authors.forename: Carlo
authors.initials: C
authors.lastname: Cirelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: d'Adamo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fanelli
mesh_terms: D001843:Bone Cements / Q000627:therapeutic use*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000295:instrumentation / Q000379:methods; D015641:Radiography, Interventional / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012399:Rotation; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D014963:X-Ray Intensifying Screens
chemical_list: D001843:Bone Cements