A Novel Approach for Percutaneous Vertebroplasty Based on Preoperative CT-based 3-Dimensional Model Design : Technical Note.

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A Novel Approach for Percutaneous Vertebroplasty Based on Preoperative CT-based 3-Dimensional Model Design : Technical Note.

World Neurosurg. 2017 May 24;:

Authors: Li J, Lin J, Xu J, Meng H, Su N, Fan Z, Li J, Yang Y, Li D, Wang B, Fei Q

Abstract
OBJECTIVE: To describe a new technique for the efficient use of preoperative planning based on preoperative CT-based 3-Dimensional model design for percutaneous vertebroplasty (PVP) in a patient with osteoporotic vertebral compression fracture (OVCF).
METHODS: A 76-year-old woman with acute OVCF (L1 level) accepted a novel precise PVP. A 3D model of thoracolumbar vertebrae (T12-L2) based on preoperative CT scanning data and a simulative PVP (via bilateral transpedicular approach) were built in Materiaise's interactive medical image control system (MIMICS) software. With the help of three radiopaque markers located at back skin and preoperative digital design by MIMICS software, bilateral skin entry points, needles direction including abduction angle and head inclination angle, and needles insertion depth were established.
RESULTS: During surgery, only 1 shot of fluoroscopy was required to confirm the skin entry points. The operation took about only 23 minutes and total patient exposure dose was 4.5 mSv. The intraoperative radiological results showed the cement distribution in L1 vertebra was very good without any puncture-related complications. The VAS score of the patient improved from preoperative 9 points to postoperative 2 points. Preoperative Oawestry Disability Index (ODI) score of the patient was 80 points, improved to postoperative 57.8 points.
CONCLUSIONS: The novel precise PVP based on preoperative 3D model design allows (1) visualization of the morphology of fractured vertebral body, (2) increased precision of puncture with decreasing incidence of puncture-related complications and reduced radiation exposure, and (3) less operation time with decreasing the learning curve of the beginners with limited experience.

PMID: 28552698 [PubMed - as supplied by publisher]

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