Vertebroplasty and kyphoplasty:entry point and angle of percutaneous pedicle positioning
10.3969/j.issn.2095-4344.2014.35.026
- VernacularTitle:椎体成形与椎体后凸成形：经皮椎弓根定位的穿刺位置及角度
- Author:
Cuihua YUAN
;
Xu WANG
;
Shoukun LIU
;
Chun WANG
- Publication Type:Journal Article
- Keywords:
vertebroplasty;
thoracic vertebrae;
lumbar vertebrae;
dissection
- From:
Chinese Journal of Tissue Engineering Research
2014;(35):5730-5735
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:The key of vertebroplasty and percutaneous kyphoplasty to success is whether the puncture needle can accurately reach the vertebral body through pedicle. Therefore, it is important to identify the correct point and direction of needling in the X-ray fluoroscopy. Among many methods published in present reports, the puncture point and the puncture angle are not fixed. Few reports concerned whether the puncture needle perforated pedicle medial wal . OBJECTIVE:To seek safe, effective puncture point and the puncture angle of percutaneous pedicle from the perspective of anatomy and radiography. METHODS:The best entry point during percutaneous vertebroplasty in the X-ray fluoroscopy:dissection was performed on thoracic, lumbar skeletal samples (T 6-L 5 ) to find the position of pedicle axis leading to the rear of the vertebral body, and this position is the best entry point of percutaneous vertebroplasty. It was fixed with mini-screw. The relationship of the best entry point and pedicle developing position in the X-ray fluoroscopy was analyzed to find the best entry point in the X-ray fluoroscopy. The best entry angle during percutaneous vertebroplasty:The average included angle of pedicle axis and vertebral sagittal line was measured using autopsy and CT scanning on adult thoracic and lumbar skeletal samples (T 6-L 5 ). The best entry angle during percutaneous vertebroplasty was found. RESULTS AND CONCLUSION:During percutaneous vertebroplasty, the best entry point in the X-ray fluoroscopy was the left pedicle projection 9 area and right pedicle projection 3 area. The optimal needle angle during percutaneous vertebroplasty:5°-10° in lumbar vertebra L1-L4;20° in L5, not more than 25°;about 5° in thoracic vertebra T6-T12 .
