Intraoperative localization of thoracic spine level with preoperative percutaneous placement of intravertebral polymethylmethacrylate
Intraoperative localization of thoracic spine level with preoperative percutaneous placement of intravertebral polymethylmethacrylate
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DOI：
10.1097/bsd.0b013e3181493194
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发表时间：
2008-02-01
影响因子：
--
通讯作者：
Murphy, Kieran
中科院分区：
文献类型：
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作者：
Hsu, Wesley;Sciubba, Daniel M.;Murphy, Kieran
目的：目的：评价术前椎体成形术在术中定位胸椎节段的安全性和实用性。背景资料概要：传统上，术中荧光透视或X线平片用于胸椎手术中胸椎节段的定位。不幸的是，由于缺乏标志、肩胛阴影和病态肥胖者的体型，在胸中部进行这种定位有时会很困难。文献中描述了多种技术，可在后路胸椎入路过程中对胸椎节段进行术前定位。为了有效和准确的术中定位胸椎水平在前胸椎手术，我们描述了一种方法，使用术前经皮放置聚甲基丙烯酸甲酯（PMMA）到椎体使用标准的vertebroplasty technique.Methods：4例病态肥胖和症状性胸椎间盘突出症进行术前椎体成形术程序使用标准的经皮技术。PMMA骨水泥被用来迅速确定胸椎利益levels using intraoperative fluoroscopy.Results：所有4例患者进行了成功的椎体成形术，无并发症。PMMA骨水泥很容易识别术中，并导致正确识别胸椎水平的interests.Conclusions：术前放置PMMA到胸椎体使用标准的椎体成形术技术提供了一种安全，有效，可靠的方法定位胸椎水平术中。这种手术可以在门诊进行，由经验丰富的医生进行时，发病率极低。这种手术应该保留给那些外科医生预计难以使用标准X线片或荧光镜在术中定位胸椎节段的患者。
Objective: To evaluate the safety and utility of preoperative vertebroplasty for intraoperative localization of thoracic spinal levels.Summary of Background Data: Intraoperative fluoroscopy or plain radiographs are traditionally used to localize thoracic spine levels during thoracic spine operations. Unfortunately, such localization can occasionally be difficult in the midthoracic levels due to lack of landmarks, scapular shadows, and the body habitus of the morbidly obese. There are multiple techniques described in the literature that allow for preoperative localization of thoracic spinal levels during approaches to the posterior thoracic spine. For efficient and accurate intraoperative localization of thoracic spinal levels during anterior thoracic spine procedures, we describe a method that uses preoperative percutaneous placement of polymethylmethacrylate (PMMA) into the vertebral body using standard vertebroplasty technique.Methods: Four patients with morbid obesity and symptomatic thoracic disc herniations underwent preoperative vertebroplasty procedures using standard percutaneous techniques. The PMMA cement was used to expeditiously identify thoracic spinal levels of interest using intraoperative fluoroscopy.Results: All 4 patients underwent successful vertebroplasty procedures without complications. The PMMA cement was easily identified intraoperatively and led to the correct identification of the thoracic spinal levels of interest.Conclusions: Preoperative placement of PMMA into thoracic vertebral bodies using standard vertebroplasty technique provides a safe, efficient, and reliable method of localizing thoracic spine levels intraoperatively. Such procedures can be performed in the outpatient setting and can be associated with extremely low morbidity when done by experienced practitioners. This procedure should be reserved for patients in whom a surgeon anticipates difficulty using standard radiographs or fluoroscopy to localize thoracic spinal levels intraoperatively.