Balloon Kyphoplasty under Three-dimensional Radiography Guidance.

Area of Science:

• Interventional Radiology
• Orthopedic Surgery
• Medical Imaging

Background:

• Percutaneous balloon kyphoplasty (PBKP) traditionally uses 2D radiography, lacking crucial Z-axis information for optimal 3D visualization.
• Limitations of 2D fluoroscopy hinder precise assessment of vertebral anatomy during PBKP.

Purpose of the Study:

• To evaluate the efficacy and safety of 3D radiography guidance in PBKP for osteoporotic vertebral fractures.
• To compare outcomes of PBKP performed with 3D versus traditional 2D radiography guidance.

Main Methods:

• Retrospective analysis of patients undergoing PBKP for single-level osteoporotic vertebral fractures from February to December 2016.
• Comparison of 16 patients treated with 3D radiography guidance versus 10 patients with 2D radiography guidance.
• Assessment of polymethyl methacrylate (PMMA) injection volume, postoperative vertebral height, and alignment.

Main Results:

• PBKP with 3D radiography guidance resulted in a significantly increased volume of PMMA injection compared to the 2D method.
• Significant improvements in postoperative vertebral height and alignment were observed in the 3D guidance group.
• No complications were reported in either the 2D or 3D radiography guidance groups.

Conclusions:

• Three-dimensional radiography guidance is a feasible and safe advancement for performing PBKP.
• The enhanced visualization provided by 3D guidance improves procedural outcomes, including cement fill and spinal restoration.
• 3D radiography guidance offers a superior approach to PBKP for managing painful osteoporotic vertebral fractures.