Related Experiment Video
Updated: Sep 7, 2026
Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
Published on: July 15, 2021
A lateral decubitus percutaneous vertebroplasty using a facet-joint-transgressing unipedicular trajectory in a
Guojun Li1, Rongjin Feng1, Tao Chen1
1Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Spine Surgery, The First Affiliated Hospital, Hainan Medical University, Haikou, China.
Background:
Percutaneous vertebroplasty (PVP) is typically performed in the prone position using a standard transpedicular approach. However, patients with hemiplegia often cannot tolerate prone positioning due to spasticity and postural instability. Moreover, achieving symmetrical cement distribution through a unilateral approach remains technically challenging. This study introduces a modified technique incorporating a facet-joint-transgressing trajectory combined with a lateral decubitus position to optimize cement dispersion.
Case Presentation:
We report a 70-year-old woman with right-sided hemiplegia following cerebral hemorrhage who presented with an acute L3 osteoporotic vertebral compression fracture. Because of intolerance to prone positioning, PVP was performed in the lateral decubitus position. A novel unilateral puncture strategy via a facet-joint-transgressing trajectory was adopted to achieve a more medialized and anterior needle placement. Cement was injected during the doughy phase, using gravitational forces to facilitate cross-midline diffusion. Postoperative imaging confirmed satisfactory bilateral cement distribution without leakage. The patient experienced immediate pain relief and significant functional improvement.
Conclusion:
This case demonstrates a novel position-trajectory-gravity coupling strategy, integrating lateral decubitus positioning with a facet-joint-transgressing unilateral approach. This technique enables effective bilateral cement distribution under constrained positioning conditions and expands the technical feasibility of PVP in patients unable to tolerate standard prone positioning.
