A modified vertebroplasty technique for intraoperative thoracic spine localisation: a technical report

The aim is to illustrate the modified vertebroplasty technique as a fixed marker for intraoperative thoracic spine localisation. Open and minimally invasive surgery in the thoracic spine has been correlated with a disproportionately high rate of wrong-level spinal surgery in pathologies where a focal deformity or fracture is absent. Spinal markers have evolved with time, and vertebroplasty as a spinal marker was initially described in 2008. A significant disadvantage is that the cement in the vertebral body and pedicle may preclude a more extensive osteotomy or subsequent instrumentation at the level of interest. We demonstrate the modified vertebroplasty technique, which introduces percutaneous polymethylmethacrylate cement two levels below the thoracic disc herniation on the contralateral side to the surgical approach using standard vertebroplasty methods. The vertebroplasty was performed as an outpatient procedure, and the radiopaque cement was instantaneously located on intraoperative fluoroscopy, identifying the correct level above. The modified vertebroplasty technique is a quick, safe and accurate method of thoracic spine localisation, facilitating the room required for the bony exposure and instrumentation if needed.