A comparison between one- and two-fluoroscopic techniques in percutaneous vertebroplasty

Area of Science:

• Interventional radiology
• Orthopaedic surgery
• Medical device technology

Background:

• Percutaneous vertebroplasty (PV) is a common procedure for osteoporotic vertebral fractures.
• Current standard practice utilizes single fluoroscopic guidance, which can be time-consuming and may delay detection of complications like cement leakage.
• This study aimed to evaluate the efficacy and safety of using one versus two fluoroscopes for PV.

Observation:

• A retrospective study compared 15 patients undergoing PV with single fluoroscopy to 28 patients with dual fluoroscopy.
• All procedures were performed by a single orthopaedic surgeon with a mean follow-up of 19 months.
• No symptomatic cement leakage or postoperative infections were reported in either group.

Findings:

• The dual-fluoroscopic technique (Group 2) resulted in a significantly shorter mean operation time (31.0 minutes) compared to the single-fluoroscopic technique (Group 1, 37.8 minutes; P = 0.03).
• The incidence of cement leakage was lower in the dual-fluoroscopy group (14.3%) versus the single-fluoroscopy group (26.7%), though this difference was not statistically significant (P = 0.19).

Implications:

• Simultaneous antero-posterior and lateral views provided by two fluoroscopes enhance real-time monitoring of entry and cement delivery during PV.
• The dual-fluoroscopic technique offers a safe, effective, and more time-efficient approach to PV without requiring complex staffing.
• This method has the potential to improve patient throughput and reduce procedural risks in vertebroplasty.