Keywords
Three-dimensional coordinate guidance system
Percutaneous kyphoplasty
Submitted : 2024-03-02
Accepted : 2024-03-17
Published : 2024-04-01
Abstract
Purpose: To investigate the clinical effect of percutaneous kyphoplasty (PKP) guided by computed tomography (CT) combined with the three-dimensional coordinate guidance system on the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: 32 cases of OVCF in the elderly admitted to our hospital from October 2019 to March 2021 underwent CT-guided PKP combined with the three-dimensional coordinate guidance system, and 36 vertebrae were treated. The patients’ VAS pain scores (visual analog scale) and ODI (Oswestry disability index) were observed after surgery, and the paired t-test was used to compare these indexes. Results: The 36 vertebrae that were treated with CT-guided PKP combined with the three-dimensional coordinate guidance system underwent unilateral pedicle puncture according to the path planned by CT images. With the ideal position of the puncture needle and a high success rate of puncture, the puncture time was 1.2–2.6 minutes, with an average of about 1.5 minutes; the injected bone cement ranged from 3 to 5.5 mL, with an average of 4.2 mL, and there were no spinal nerve injuries or leakage of the cement in the canal. VAS score decreased from 7.65 ± 0.60 before the operation to 2.59 ± 0.28 one day after the operation (P < 0.01); ODI decreased from 62.3 ± 2.18 before the operation to 27.91 ± 1.32 after the operation (P < 0.01). Conclusion: The application of CT-guided PKP combined with the three-dimensional coordinate guidance system has the advantages of accurate puncture, short operation time, less intraoperative bleeding, and low complications. This treatment is safe, reliable, and satisfactory for patients, and is worthy of clinical promotion.
References
Phillips FM, Wetzel FT, Lieberman I, et al., 2002, An In Vivo Comparison of the Potential for Extravertebral Cement Leak After Vertebroplasty and Kyphoplasty. Spine, 27(19): 2173–2178.
Phillips FM, 2003, Minimally Invasive Treatments of Osteoporotic Vertebral Compression Fractures. Spine, 28(15 Suppl): S45–S53.
Bonnard E, Foti P, Kastler A, et al., 2017, Percutaneous Vertebroplasty Under Local Anaesthesia: Feasibility Regarding Patients’ Experience. Eur Radiol, 27(4): 1512–1516. http://doi.org/10.1007/s00330-016-4521-1
Li HD, Xu CJ, Wang H, et al., 2015, Percutaneous Vertebroplasty for Single Osteoporotic Vertebral Body Compression Fracture: Results of Unilateral 3D Percutaneous Puncture Technique. Indian J Orthop, 49(2): 245–250.
Yi X, Lu H, Tian F, et al., 2014, Recompression in New Levels After Percutaneous Vertebroplasty and Kyphoplasty Compared with Conservative Treatment. Arch Orthop Trauma Surg, 134(1): 21–30.
Lamy O, Uebelhart B, Aubry–Rozier B, 2014, Risks and Benefits of Percutaneous Vertebroplasty or Kyphoplasty in the Management of Osteoporotic Vertebral Fractures. Osteoporos Int, 25(3): 807–819.
Huwart L, Foti P, Andreani O, et al., 2014, Vertebral Split Fractures: Technical Feasibility of Percutaneous Vertebroplasty. Eur J Radiol, 83(1): 173–178.
Guo WH, Meng MB, You X, et al., 2012, CT–Guided Percutaneous Vertebroplasty of the Upper Cervical Spine Via a Translateral Approach. Pain Physician, 15(5): 733–741.
Lieberman IH, Togawa D, Kayanja MM, 2005, Vertebroplasty and Kyphoplasty: Filler Materials. Spine J, 2005(5): 305–316.
Hadjipavlou AG, Tzermiadianos MN, Katonis PG, et al., 2005, Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures and Osteolytic Tumours. J Bone Joint Surg Br, 2005(87): 1595–1604.
Chen L, Yang H, Tang T, 2009, Analysis of the Efficacy of Unilateral and Bilateral Vertebral Kyphoplasty in the Treatment of Multi-Vertebral Osteoporotic Compression Fractures. Chinese Journal of Surgery, 47(21): 1546–1642.
Zheng SM, Li FB, 2007, How to Choose Percutaneous Vertebroplasty or Percutaneous Kyphoplasty. Chinese Journal of Spine and Spinal Cord, 17(5): 327–328.
Li LH, Sun TS, Liu Z, et al., 2013, Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Treating Osteoporotic Vertebral Compression Fractures: A Meta-Analysis. Chin Med J(Engl), 126(20): 3956–3961.
Huang Z, Wan S, Ning L, et al., 2014, Is Unilateral Kyphoplasty as Effective and Safe as Bilateral Kyphoplasties for Osteoporotic Vertebral Compression Fractures? A Meta-Analysis. Clin Orthop Relat Res, 472(9): 2833–2842.
Rebolledo BJ, Gladnick BP, Unnanuntana A, et al., 2013, Comparison of Unipedicular and Bipedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: A Prospective Randomised Study. Bone Joint J Br, 95(3): 401–406.
Papadopoulos EC, Edobor-Osula F, Gardner MJ, et al., 2008, Unipedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: Early Results. J Spinal Disord Tech, 21(8): 589–596.
Song BK, Eun JP, Oh YM, 2009, Clinical and Radiological Comparison of Unipedicular Versus Bipedicular Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures. Osteoporos Int, 20(10): 1717–1723.
Ge Z, Ma R, Zhang H, et al., 2013, Uniextrapedicular Kyphoplasty for the Treatment of Thoracic Osteoporotic Vertebral Fractures. Orthopedics, 36(8): 1020–1024.
Chen PL, Hsieh DF, Lai YQ, et al., 2011, Effect of Unilateral PKP Cement Injection Over Midline Distribution on the Stiffness of Compression Fracture Vertebrae on Both Sides. Chinese Spinal Cord Journal, 21(2): 118–121.
Cheng X, Long HQ?Xu JH, et al., 2016, Comparison of Unilateral Versus Bilateral Percutaneous Kyphoplasty for the Treatment of Patients with Osteoporosis Vertebral Compression Fracture (OVCF): A Systematic Review and Meta-Analysis. Eur Spine J, 25(11): 3439–3449.
Sun Q, Xu L, 2009, Intraoperative Three-Dimensional Spinal Navigation-Guided Vertebroplasty for Vertebral Compression Fracture. Chinese Journal of Orthopaedic Surgery, 17(12): 891–894.
Arand M, Hartwig E, Kinzl L, et al., 2001, Spinal Navigation in Cervical Fractures- A Preliminary Clinical Study on Judet-Osteosynthesis of the Axis. Comput Aided Surg, 2001(6): 170–175.
Li C, Zhang H, Chen G, et al., 2011, Study of CT-Guided PKP Surgery in Clinical Application. Journal of Practical Orthopaedics, 17(12): 1106–1108.
Xiong X, Song Y, Wan D, et al., 2012, Unilateral Approach Percutaneous Vertebral Kyphoplasty for Vertebral Compression Fracture Guided by CT Imaging Data. Chinese Journal of Orthopaedic Surgery, 20(22): 2035–2038.
Ma D, Wang T, Zhang W, et al., 2017, Comparison of CT-Guided PKP Surgery for Vertebral Fracture with C-Arm Fluoroscopy. Journal of practical orthopedics, 23(5): 441–444.
Rauschmann MA, Von Stechow D, Thomann KD, et al., 2004, Complications of Vertebroplasty. Orthopade, 33(1): 40–47.