1. Projection of the Most Anterior Line of the Spinal Canal on Lateral Radiograph: An Anatomic Study for Percutaneous Kyphoplasty and Percutaneous Vertebroplasty.
- Author
-
Zhang H, Xuan J, Chen TH, Chen ZX, Sun LJ, Tian NF, Zhang XL, Wang XY, Lin Y, and Wu YS
- Subjects
- Adult, Aged, Bone Cements adverse effects, Cadaver, Fluoroscopy, Humans, Kyphoplasty adverse effects, Male, Middle Aged, Osteoporotic Fractures surgery, Postoperative Complications etiology, Retrospective Studies, Spinal Canal diagnostic imaging, Tomography, X-Ray Computed, Treatment Outcome, Vertebroplasty adverse effects, Kyphoplasty methods, Postoperative Complications prevention & control, Spinal Canal anatomy & histology, Vertebroplasty methods
- Abstract
ABSTRACT To measure the projection of the most anterior line of the spinal canal on lateral radiographs of the vertebra (C3-L5) and evaluate the efficacy of the safety line (SL) in preventing intraspinal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Purpose: To measure the projection of the most anterior line of the spinal canal on lateral radiographs of the vertebra (C3-L5) and evaluate the efficacy of the safety line (SL) in preventing intraspinal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Materials and Methods: Fifteen adult dry-bone spine specimens were analyzed. The projection of the SL was viewed on lateral radiographs. The distance between the SL and the posterior vertebral body line (PVBL) was measured. Two groups of patients were treated by PKP, and cement injection was stopped either before the PBVL (group 1) or before the SL (group 2) under lateral fluoroscopy. The rate of cement leakage was compared between the two groups. Results: The largest distance between the SL and PVBL was at L1 (5.22 ± 0.62 mm). From L1 to L5, the distance decreased progressively to 1.05 ± 0.64 mm. Similar variation was also observed from L1 to T1 (0.19 ± 0.18 mm). The postoperative computed tomography scan was more sensitive and accurate in detecting intraspinal leakage than radiography in group 1 ( p = 0.000); however, there was no significant difference in sensitivity or accuracy between methods in group 2 ( p = 0.063). The rate of intraspinal cement leakage was significantly higher in group 1 than group 2 ( p = 0.000). Conclusions: The operator should frequently check to ensure that cement injection has stopped upon reaching the SL. Surgeons may benefit from this quantitative anatomical study of PKP and PVP.
- Published
- 2020
- Full Text
- View/download PDF