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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
C-arm cone-beam CT: applications for spinal cement augmentation demonstrated by three cases
Jesse R Knight1, Manraj Heran, Peter L Munk
1Angiography and Interventional Radiology Section, Inland Imaging, 801 South Stevens Street, Spokane, WA 99204, USA.
Summary
Spinal canal narrowing from retropulsion is no longer a contraindication for cement augmentation therapy. Novel C-arm cone-beam CT imaging allows safe visualization, confirming adequate bone filling and extrusion endpoints.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Radiology
Background:
- Spinal canal narrowing due to retropulsion of spinal structures was a contraindication for cement augmentation.
- This limited treatment options for certain spinal compression fractures.
Observation:
- Three cases of spinal compression fractures were treated with cement augmentation.
- A novel application of C-arm cone-beam computed tomography (CT) was utilized during the procedure.
Findings:
- Small amounts of posterior cement extrusion occurred in all cases.
- Osteotomy needles remained in place during C-arm cone-beam CT imaging.
- Rapidly reformatted images with bone windows provided 3D visualization, confirming extrusion endpoints and adequate bone filling.
Implications:
- This technique enables safe cement augmentation in cases previously considered contraindicated.
- C-arm cone-beam CT offers precise intraoperative assessment of cement placement.
- Expanded treatment possibilities for spinal compression fractures with posterior element involvement.