Percutaneous vertebroplasty with the rotational fluoroscopy imaging technique

Area of Science:

• Interventional Radiology
• Medical Imaging
• Orthopedic Surgery

Background:

• Percutaneous vertebroplasty (PVP) is a minimally invasive procedure to treat vertebral compression fractures.
• Current guidance techniques often involve multiple imaging modalities, potentially increasing procedure time and radiation exposure.

Purpose of the Study:

• To assess the feasibility of using rotational angiography unit (RAU) fluoroscopy as a standalone technique for guiding PVP.
• To compare the efficacy and safety of RAU-guided PVP with conventional CT and C-arm fluoroscopy guidance.

Main Methods:

• A prospective study of 25 patients undergoing PVP using RAU fluoroscopy for 35 vertebral bodies.
• Rotational acquisitions for 2D/3D reconstructions were performed using a flat-panel angiographer.
• Outcomes including procedure time, fluoroscopy time, radiation dose, technical success, and complications were recorded and compared to a historical control group.

Main Results:

• RAU guidance enabled safe and accurate needle insertion and cement injection with high-quality imaging.
• The RAU group demonstrated significantly reduced mean procedure time (38.2 min vs. 60.2 min) and radiation dose (6 ± 1.3 mSv vs. 23 ± 1.3 mSv) compared to the control group.
• Complication rates were comparable, with minor events in 8% of the RAU group and 12% of the control group.

Conclusions:

• Rotational angiography unit guidance is an effective and safe single-modality technique for percutaneous vertebroplasty.
• RAU guidance offers significant advantages by reducing procedural time and patient radiation exposure.