title: Percutaneous vertebroplasty guided by preoperative computed tomography measurements.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PVP) is now widely performed to treat painful vertebral compression fractures. Previous researches have reported numerous advantages. However, it rarely reported that how to determine the feasibility of the unilateral or bilateral approach and how to decide the puncture angle, the skin insertion site before the procedure. The aim of this study was to discuss the feasibility of PVP using unilateral pedicular approach by the three-dimensional positioning of computed tomography (CT) image.
  
  
  METHODS
  Under fluoroscopic guidance, 108 patients with 115 diseased vertebral bodies underwent PVP. The study was divided in two groups. Group A, fifty patients with 52 vertebrae received PVP without using preoperative CT measurements and puncture simulation. Group B, 58 patients with 63 vertebrae received PVP using preoperative CT measurements and puncture simulation. The skin needle entry point and puncture angle of the transverse plane and sagittal plane were determined by the software of PACS on preoperative CT image. The choice of unilateral or bilateral pedicular approach was decided based on the CT image before the procedure. PVP was carried out according to the measurement result above. The average time for a single vertebra operation, the success rate of single puncture and complications was evaluated and compared between Group A and Group B.
  
  
  RESULTS
  In Group A, technical success of unilateral PVP was 63.5% (33/52 vertebrae), and 92% (58/63 vertebrae) in Group B. The average time of operation in Groups A and B were (37.5 ± 5.5) and (28.5 ± 5.5) min, respectively. There was a significant difference in the time of single-vertebra operation and the success rates of unilateral PVP between Groups A and B. No serious complications developed during the followup period.
  
  
  CONCLUSIONS
  The CT three-dimensional positioning measurement for PVP can increase the success rate of unilateral PVP.
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Zhongbao
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Zhenhai
authors.initials: Z
authors.lastname: Di
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Xuequn
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zou
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Wang
keywords: CAT scan; Computed tomography image; Spinal injury; back pain; bone cements; percutaneous vertebroplasty; three-dimensional localization; unilateral pedicular approach; vertebrae