Jae-Hyuk Shin1, Je Hoon Jeong. 1. Department of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: Percutaneous vertebroplasty (PVP) is usually carried out under three-dimensional (2D) fluoroscopic guidance. However, operative complications or bone cement distribution might be difficult to assess on the basis of only 2D radiographic projection images. We evaluated the feasibility of performing an intraoperative and postoperative examination in patients undergoing PVP by using three-dimensional (3D) reconstructive C-arm. METHODS: Standard PVP procedures were performed on 14 consecutive patients by using a Siremobil Iso-C(3D) and a multidetector computed tomography machine. Post-processing of acquired volumetric datasets included multiplanar reconstruction (MPR) and surface shaded display (SSD). We analyzed intraoperative and immediate postoperative evaluation of the needle trajectory and bone cement distribution. RESULTS: THE MALE : female ratio was 2 : 12; mean age of patients, 70 (range, 77-54) years; and mean T score, -3.4. The mean operation time was 52.14 min, but the time required to perform and post-process the rotational acquisitions was 7.76 min. The detection of bone cement distribution and leakage after PVP by using MPR and SSD was possible in all patients. However, detection of the safe trajectory for needle insertion was not possible. CONCLUSION: 3D rotational image acquisition can enable intra- or post-procedural assessment of vertebroplasty procedures for the detection of bone cement distribution and leakage. However, it is difficult to assess the safe trajectory for needle insertion.
OBJECTIVE: Percutaneous vertebroplasty (PVP) is usually carried out under three-dimensional (2D) fluoroscopic guidance. However, operative complications or bone cement distribution might be difficult to assess on the basis of only 2D radiographic projection images. We evaluated the feasibility of performing an intraoperative and postoperative examination in patients undergoing PVP by using three-dimensional (3D) reconstructive C-arm. METHODS: Standard PVP procedures were performed on 14 consecutive patients by using a Siremobil Iso-C(3D) and a multidetector computed tomography machine. Post-processing of acquired volumetric datasets included multiplanar reconstruction (MPR) and surface shaded display (SSD). We analyzed intraoperative and immediate postoperative evaluation of the needle trajectory and bone cement distribution. RESULTS: THE MALE : female ratio was 2 : 12; mean age of patients, 70 (range, 77-54) years; and mean T score, -3.4. The mean operation time was 52.14 min, but the time required to perform and post-process the rotational acquisitions was 7.76 min. The detection of bone cement distribution and leakage after PVP by using MPR and SSD was possible in all patients. However, detection of the safe trajectory for needle insertion was not possible. CONCLUSION: 3D rotational image acquisition can enable intra- or post-procedural assessment of vertebroplasty procedures for the detection of bone cement distribution and leakage. However, it is difficult to assess the safe trajectory for needle insertion.
Entities:
Keywords:
Complication; Feasibility; Intraoperative 3D imaging; Vertebroplasty
Authors: Ann K Kim; Mary E Jensen; Jacques E Dion; Patricia A Schweickert; Timothy J Kaufmann; David F Kallmes Journal: Radiology Date: 2002-03 Impact factor: 11.105
Authors: Ulrich Linsenmaier; Clemens Rock; Ekkehard Euler; Stefan Wirth; Roland Brandl; Dorothea Kotsianos; Wolf Mutschler; Klaus Jürgen Pfeifer Journal: Radiology Date: 2002-07 Impact factor: 11.105
Authors: J B Martin; B Jean; K Sugiu; D San Millán Ruíz; M Piotin; K Murphy; B Rüfenacht; M Muster; D A Rüfenacht Journal: Bone Date: 1999-08 Impact factor: 4.398
Authors: A Cotten; F Dewatre; B Cortet; R Assaker; D Leblond; B Duquesnoy; P Chastanet; J Clarisse Journal: Radiology Date: 1996-08 Impact factor: 11.105