title: Gold fiducials are a unique marker for localization in the thoracic spine: a cost comparison with percutaneous vertebroplasty.
abstract: We present a unique application of the gold fiducial as a preoperative, radiographic marker placed in the thoracic spine and used for intraoperative localization. In comparison to percutaneous vertebroplasty marking of thoracic spinal levels with polymethyl methacrylate (PMMA) cement, implantation of the gold fiducial is technically facile with a minimal learning curve. The fiducial markers are also associated with significantly less financial resources. Following 2013 Current Procedural Terminology (CPT) coding, the cost of vertebroplasty under fluoroscopic guidance, $3195·43, or under computed tomography (CT) guidance, $3232·54, is more than double the cost of the gold fiducial implantation - $1237·55 and $1267·03, under similar imaging techniques, respectively. In the first description of gold fiducials in the thoracic spine, we conclude that the marker is a safe and cost-effective method for preoperative localization of the thoracic levels.
authors: Mohamed
authors: M
authors: Macki
authors: Mohamad
authors: M
authors: Bydon
authors: Kelly
authors: K
authors: McGovern
authors: Nicholas
authors: N
authors: Abt
authors: Rafael
authors: R
authors: de la Garza-Ramos
authors: Neal
authors: N
authors: Naff
authors: Ali
authors: A
authors: Bydon
mesh_terms: D004621:Embolization, Therapeutic / Q000191:economics / Q000379:methods; D057918:Fiducial Markers / Q000191:economics*; D005471:Fluoroscopy / Q000191:economics / Q000379:methods; D017612:Gold Compounds / Q000191:economics*; D006801:Humans; D019904:Polymethyl Methacrylate / Q000191:economics; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods; D054854:Vertebroplasty / Q000191:economics / Q000379:methods
chemical_list: D017612:Gold Compounds; D019904:Polymethyl Methacrylate
keywords: Fiducial,; Gold,; Pedicle,; Spine,; Thoracic