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Vertebroplasty in the mid- and upper thoracic spine
David F Kallmes1, Patricia A Schweickert, William F Marx
1Department of Radiology, University of Virginia Health Services, Charlottesville, VA 22908, USA.
AJNR. American Journal of Neuroradiology
|August 10, 2002
Summary
Percutaneous vertebroplasty effectively treats painful mid- and upper thoracic spine fractures. This minimally invasive procedure using 11-gauge needles offers significant pain relief with a low complication rate.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Radiology
Background:
- Vertebroplasty in the mid- and upper thoracic spine poses unique technical challenges compared to lower regions.
- Osteoporotic compression fractures in this area can cause significant pain and disability.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous vertebroplasty for treating painful osteoporotic compression fractures in the mid- and upper thoracic spine (T4-T8).
Main Methods:
- Retrospective chart review of 41 patients (63 vertebral bodies) undergoing vertebroplasty.
- Data collected included vertebral body compression, needle size, surgical approach, cement volume, clinical outcomes, and complications.
- Focus on transpedicular approach and use of 11-gauge needles.
Main Results:
- Significant reduction in pain intensity (mean 9.7 to 1.7, P <.0001) and medication scores.
- Unipediculate injections were more common (81%) than bipediculate (19%).
- 11-gauge needles were used in 73% of injections; low complication rate (1.3% pedicle fracture, 1.3% infection, 0% pneumothorax).
Conclusions:
- Transpedicular vertebroplasty is a safe and effective treatment for mid- and upper thoracic osteoporotic compression fractures.
- Utilizing 11-gauge needles facilitates the procedure and contributes to excellent pain relief and minimal complications.