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Updated: Jun 16, 2026
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty
Alda L Tam1, Ashraf Mohamed, Marcus Pfister
1Section of Interventional Radiology, Division of Diagnostic Radiology, University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. alda.tam@di.mdacc.tmc.edu
C-arm cone beam computed tomography (CBCT) with fluoroscopic overlay enables accurate needle guidance for vertebroplasty. This technology facilitates safe and reliable unilateral treatment of thoracic and lumbar vertebral bodies, particularly with extrapedicular approaches.
Area of Science:
- Interventional radiology
- Medical imaging technology
- Spinal procedures
Background:
- C-arm cone beam computed tomography (CBCT) provides advanced 3-D imaging.
- Fluoroscopic overlay integrates real-time imaging with cross-sectional data.
- This technology enhances needle guidance in interventional suites.
Purpose of the Study:
- To evaluate the early clinical use of C-arm CBCT with fluoroscopic overlay.
- To assess its efficacy for needle guidance during vertebroplasty.
Main Methods:
- Retrospective review of 10 oncology patients undergoing 13 vertebroplasties.
- Utilized C-arm CBCT with fluoroscopic overlay for needle guidance.
- Assessed technical success based on needle tip accuracy within 5 mm of target parameters.
Main Results:
- Technical success rates ranged from 75% to 100% across measured parameters.
- 92% accuracy was achieved for planned path and midline needle placement.
- No major complications occurred; 25% had minor cement extravasation.
Conclusions:
- C-arm CBCT with needle path overlay is feasible for fluoroscopic-guided vertebroplasty.
- Reliable unilateral therapy of thoracic and lumbar vertebral bodies is achievable.
- Extrapedicular approaches demonstrated safety and good target accuracy.
