[Modified percutaneous vertebroplasty assisted by preoperative CT-based digital design: a new technique for...

To report a new technique of modified percutaneous vertebroplasty (PVP) assisted by preoperative CT-based digital design for osteoporotic vertebral compression fracture (OVCF), and to discuss its preliminary clinical results.

Thoracolumbar spine segment data (Dicom format) were obtained from lamellar CT scanning of seven old female or male with single OVCF. A three-dimensional model of thoracolumbar spine and simulative PVP models (via double transpedicular approach) were built in the Mimics software. With the help of a preoperative transparent marker located at the back midline skin and preoperative digital design by Mimics software, the needle insert point and needle direction in every patient were established. The surgical time, the number of intraoperative radiation perspective, bone cement filling condition in fracture vertebra, intraoperative complications and visual analogue scale (VAS) scores before and after surgery were recorded to evaluate the preliminary clinical results after modified PVP.

The puncture process during PVP was in high accordance with the preoperative digital design by Mimics software in seven cases of single OVCF with the average age of 78 years old. The operation time was only 16.57±2.07 minutes and the intraoperative radiation perspective numbers were less than ten (7.86±1.68) times. The bone cement filling in all fracture vertebras were good and no surgical complications such as spine cord injury and cement leakage were founded. The VAS scores before and after surgery were 8.57±0.53 points and 1.43±0.53 point (P=0.000), respectively.

Percutaneous vertebroplasty (PVP) assisted by preoperative CT-based digital design has high accuracy, which is expected to reduce operation time, intraoperative radiation exposure and the surgical complications related to puncture failure.