title: Percutaneous vertebroplasty for single osteoporotic vertebral body compression fracture: Results of unilateral 3-D percutaneous puncture technique.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PVP) has been gradually used for osteoporotic vertebral compression fracture (OVCF) treatment, but severe osteoporotic vertebral body compression fractures (sOVCFs) due to the difficulty in performing a puncture and the characteristics of the fractured vertebrae, it has been considered as a contraindication to PVP. The aim of the following study was to evaluate the feasibility of a unilateral, three-dimensional (3D), accurate puncture in percutaneous vertebroplasty (PVP) for a single, severely osteoporotic vertebral body compression fracture (ssOVCFs).
  
  
  METHODS
  57 patients received PVP in the current study. Feasibility of a unilateral approach was judged before surgery using the 64-slice helical computed tomography (CT) multiplanar reconstruction technique, a 3D accurate puncture plan was then determined. The skin bone distance, puncture angle and needle insertion depth were recorded during surgery. 2D CT rechecking was performed for any complication at day 1 after operation. Preoperative and postoperative numerical data were compared.
  
  
  RESULTS
  The procedure was completed smoothly in all patients. 2D CT scanning at day 1 after operation did not show any puncture related complications. Visual analog scoring (VAS) showed that the score at day 3 after surgery was reduced to 1.7 ± 0.4 (0-2.9 scale) from the preoperative 7.9 ± 2.1 (6.1-9.5 scale). No significant differences in measure numerical data were found before and after the surgery. At 12 months followup three patients presented with nonadjacent level fractures, VAS for other patients were 1.2 ± 0.3 (0-2.1 scale).
  
  
  CONCLUSIONS
  Application of CT scanning for a unilateral 3D puncture design helps realize an accurate puncture in PVP. It is a safe and effective method for ssOVCFs treatment.
authors.affiliation: Department of Radiology, Zibo Qidu Hospital, Zibo 255400, Shan Dong, China.
authors.forename: Hong-De
authors.initials: HD
authors.lastname: Li
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Southeast University, Nanjing, 21003, China.
authors.forename: Chuan-Jun
authors.initials: CJ
authors.lastname: Xu
authors.affiliation: Department of Radiology, Zibo Qidu Hospital, Zibo 255400, Shan Dong, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiology, Zibo Qidu Hospital, Zibo 255400, Shan Dong, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Radiology, Zibo Qidu Hospital, Zibo 255400, Shan Dong, China.
authors.forename: Xi-Jing
authors.initials: XJ
authors.lastname: Jiang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Southeast University, Nanjing, 21003, China.
authors.forename: Xi-Qi
authors.initials: XQ
authors.lastname: Zhu
keywords: Percutaneous vertebroplasty; Spine; osteoporotic fractures; severe vertebral body compression fractures; three-dimensional accurate puncture; vertebroplasty