Skip to main content
SpringerLink
Log in

Percutaneous vertebroplasty with the rotational fluoroscopy imaging technique

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the feasibility of the rotational angiography unit (RAU) as a single technique to guide percutaneous vertebroplasty (PVP).

Materials and methods

Twenty-five consecutive patients (35 vertebral bodies, 20 lumbar and 15 thoracic) were treated using RA fluoroscopy. Using a state-of-the-art flat-panel angiographer (Artis zee, Siemens, Erlangen, Germany), rotational acquisitions were obtained in all patients for immediate post-procedure 2D/3D reconstructions. Pre- and postoperative back pain was assessed with the visual analog scale (VAS). Fluoroscopy time, patient radiation dose exposure, technical success, mean procedure time, mean number of rotational acquisitions and procedural complications were recorded. All features were compared with a historical cohort of patients (N = 25) who underwent PVP under CT and mobile C-arm fluoroscopy guidance.

Results

In all cases, safe and accurate control of the needle insertion and bone-cement injection was successfully obtained with high-quality fluoroscopy images. One cement leakage was detected in the RAU group, and two leakages were detected in the CT and C-arm fluoroscopy group. Technical features were significantly different between the two groups (RAU vs. CT): mean procedure time: 38.2 min vs. 60.2 min (p = 0.02); median fluoroscopy time: 14.58 and 4.58 min (p = 0.02); median number of rotational acquisitions: 5 vs. 10 (p = 0.02); mean patient dose: 6 ± 1.3 mSv vs. 23 ± 1.3 mSv (p = 0.02). There were minor complications (pain, small hematoma) in two patients (8%) in the study group and three cases (12%) in the control group.

Conclusion

RAU guidance is an effective and safe technique for performing PVP because it reduces the procedural time and radiation exposure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gangi A, Kastler BA, Dietemann JL. Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol. 1994;15(1):83–6.

    PubMed  CAS  Google Scholar 

  2. Gangi A, Sabharwal T, Irani FG, Buy X, Morales JP, Adam A. Standards of practice committee of the society of interventional radiology. Quality assurance guidelines for percutaneous vertebroplasty. Cardiovasc Intervent Radiol. 2006;29(2):173–8.

    Article  PubMed  Google Scholar 

  3. Anselmetti GC, Marcia S, Saba L, et al. Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol. 2012;81(12):4083–6.

    Article  PubMed  Google Scholar 

  4. Anselmetti GC, Bonaldi G, Carpeggiani P, Manfrè L, Masala S, Muto M. Vertebral augmentation: 7 years experience. Acta Neurochir Suppl. 2011;108:147–61.

    Article  PubMed  Google Scholar 

  5. Kevin McGraw J, Cardella J, Barr JD, et al. Society of interventional radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol. 2003;14:827–31.

    Article  PubMed  Google Scholar 

  6. European guidelines on quality criteria for computed tomography. Office for Official Publications of the European Communities, 1999, Luxembourg.

  7. Mathis JM, Wong M. Percutaneous vertebroplasty: technical considerations. J Vasc Interv Radiol. 2003;14(8):953–60.

    Article  PubMed  Google Scholar 

  8. Peh WC, Gilula LA. Percutaneous vertebroplasty: indications, contraindications, and technique. Br J Radiol. 2003;76(901):69–75.

    Article  PubMed  CAS  Google Scholar 

  9. Eckel TS, Olan W. Vertebroplasty and vertebral augmentation techniques. Tech Vasc Interv Radiol. 2009;12(1):44–50.

    Article  PubMed  Google Scholar 

  10. Katsanos K, Sabharwal T, Adam A. Percutaneous cementoplasty. Semin Interv Radiol. 2010;27(2):137–47.

    Article  Google Scholar 

  11. Amoretti N, Marcy PY, Lesbats-Jacquot V, et al. Combined CT and fluoroscopic guidance of balloon kyphoplasty versus fluoroscopy-only procedures. Skeletal Radiol. 2009;38(7):703–7.

    Article  PubMed  Google Scholar 

  12. Trumm CG, Jakobs TF, Zech CJ, et al. Vertebroplasty in the treatment of back pain. Radiologe. 2006;46(6):495–505.

    Article  PubMed  CAS  Google Scholar 

  13. Joemai RM, Zweers D, Obermann WR, Geleijns J. Assessment of patient and occupational dose in established and new applications of MDCT fluoroscopy. AJR Am J Roentgenol. 2009;192(4):881–6.

    Article  PubMed  Google Scholar 

  14. Kloeckner R, Santos DP, Schneider J, Kara L, Dueber C, Pitton MB. Radiation exposure in CT-guided interventions. Eur J Radiol. 2013;82(12):2253–7.

    Article  PubMed  Google Scholar 

  15. Pedicelli A, Rollo M, Piano M, Re TJ, Cipriani MC, Colosimo C, et al. Percutaneous vertebroplasty with a high-quality rotational angiographic unit. Eur J Radiol. 2009;69(2):289–95.

    Article  PubMed  Google Scholar 

  16. Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JP. Real-Time 3D fluoroscopy guidance during needle interventions: technique, accuracy, and feasibility. AJR Am J Roentgenol. 2010;194(5):W445–51.

    Article  PubMed  CAS  Google Scholar 

  17. Tam AL, Mohamed A, Pfister M, et al. C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty. Spine (Phila Pa 1976) 2010;35(10):1095–9.

  18. Leschka SC, Babic D, El Shikh S, Wossmann C, Schumacher M, Taschner CA. C-arm cone beam computed tomography needle path overlay for image-guided procedures of the spine and pelvis. Neuroradiology. 2012;54(3):215–23.

    Article  PubMed  Google Scholar 

  19. Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Sawada S. Radiation exposure to operators during vertebroplasty. J Vasc Interv Radiol. 2005;16(10):1327–32.

    Article  PubMed  Google Scholar 

  20. Amoretti N, Lesbats V, Marcy PY, et al. Dual guidance (CT and fluoroscopy) vertebroplasty: radiation dose to radiologists. How much and where? Skeletal Radiol. 2010;39(12):1229–35.

    Article  PubMed  Google Scholar 

  21. Tappero C, Barbero S, Costantino S, et al. Patient and operator exposure during percutaneous vertebroplasty. Radiol Med. 2009;114(4):595–607.

    Article  PubMed  CAS  Google Scholar 

  22. Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol. 2004;33(9):493–505.

    Article  PubMed  CAS  Google Scholar 

  23. Martin DJ, Rad AE, Kallmes DF. Prevalence of extravertebral cement leakage after vertebroplasty: procedural documentation versus CT detection. Acta Radiol. 2012;53(5):569–72.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

The authors declare that they have no conflict of interest and have no financial relationship with any organization in relation to this manuscript.

Author information

Authors and Affiliations

  1. Vascular and Interventional Unit, Department of Radiological Sciences, “Sapienza” University of Rome, 324 Viale Regina Elena, Rome, 00161, Italy

    Alessandro Cannavale, Filippo Maria Salvatori, Andrea Wlderk, Carlo Cirelli, Alessandro d’Adamo & Fabrizio Fanelli

Authors
  1. Alessandro Cannavale
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Filippo Maria Salvatori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Wlderk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlo Cirelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alessandro d’Adamo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fabrizio Fanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Cannavale.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cannavale, A., Salvatori, F.M., Wlderk, A. et al. Percutaneous vertebroplasty with the rotational fluoroscopy imaging technique. Skeletal Radiol 43, 1529–1536 (2014). https://doi.org/10.1007/s00256-014-1925-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-014-1925-3

Keywords

Search

Navigation