title: Treatment of vertebral body compression fractures using percutaneous kyphoplasty guided by a combination of computed tomography and C-arm fluoroscopy with finger-touch guidance to determine the needle entry point.
abstract: This study aimed to evaluate the results and complications of image-guided percutaneous kyphoplasty (PKP) using computed tomography (CT) and C-arm fluoroscopy, with finger-touch guidance to determine the needle entry point. Of the 86 patients (106 PKP) examined, 56 were treated for osteoporotic vertebral compression fractures and 30 for vertebral tumors. All patients underwent image-guided treatment using CT and conventional fluoroscopy, with finger-touch identification of a puncture point within a small incision (1.5 to 2 cm). Partial or complete pain relief was achieved in 98% of patients within 24 h of treatment. Moreover, a significant improvement in functional mobility and reduction in analgesic use was observed. CT allowed the detection of cement leakage in 20.7% of the interventions. No bone cement leakages with neurologic symptoms were noted. All work channels were made only once, and bone cement was distributed near the center of the vertebral body. Our study confirms the efficacy of PKP treatment in osteoporotic and oncological patients. The combination of CT and C-arm fluoroscopy with finger-touch guidance reduces the risk of complications compared with conventional fluoroscopy alone, facilitates the detection of minor cement leakage, improves the operative procedure, and results in a favorable bone cement distribution.
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China wangguangye@126.com.
authors: G Y
authors: GY
authors: Wang
authors: Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA, Shanghai, China.
authors: C C
authors: CC
authors: Zhang
authors: Department of Orthopedics, Gen Hospital of Nanjin Military Area Command, Nanjin, Jiangsu, China.
authors: K
authors: K
authors: Ren
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China.
authors: P P
authors: PP
authors: Zhang
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China.
authors: C H
authors: CH
authors: Liu
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China.
authors: Z A
authors: ZA
authors: Zheng
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China.
authors: Y
authors: Y
authors: Chen
authors: Department of Orthopedics, Wuhu No. 2 People's Hospital, Wannan Medical College, Anhui, China.
authors: R
authors: R
authors: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000033:anatomy & histology*; D001843:Bone Cements; D001859:Bone Neoplasms / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D050815:Fractures, Compression / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009339:Needles; D010024:Osteoporosis / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D001843:Bone Cements