Amoretti Nicolas, Marcy Pierre-Yves, Lesbats-Jacquot Virginie, Hovorka Istvan, Fonquerne Marie-Eve, Roux Christian, Hericord Olivier, Maratos Yvonne, Euller-Ziegler Liana
Service de Radiologie, Centre Hospitalier Universitaire de Nice, Route de Saint Antoine de Ginestiere, Nice 06200, France.
Skeletal Radiol. 2009 Jul;38(7):703-7. doi: 10.1007/s00256-008-0585-6. Epub 2008 Oct 1.
To evaluate the performance of combined (computed tomography (CT) and fluoroscopic) guidance of balloon kyphoplasty in comparison to fluoroscopic guidance alone.
Forty-one kyphoplasties were performed between January 2005 and March 2006 according to two different protocols. Study group 1 consisted of 20 consecutive patients with 20 balloon kyphoplasty procedures under dual guidance (CT scan and fluoroscopy) for osteoporotic or traumatic vertebral fractures. Study group 2 consisted of 21 consecutive patients in whom kyphoplasty was performed with fluoroscopy alone. Visualization of the pedicles, the final of the balloon position, and cement distribution were evaluated(1-poor, 2-intermediate, 3-good).
Combined use of CT and fluoroscopy (group 1) was superior in identifying the pedicles (100% versus 66.7%, p = 0.009) and balloon placement (100% versus 71.4%, p = 0.02) but not in monitoring of cement distribution within the vertebral body (100% versus 90.5%, p = 0.49). The difference between the two groups was more pronounced in the thoracic spine than in the lumbar spine.
CT/fluoroscopic guidance of kyphoplasty combines safe CT-guided insertion of the osteointroducers and balloons as well as fluoroscopic real-time monitoring of polymethylmethacrylate injection.
评估与单纯透视引导相比，联合（计算机断层扫描（CT）和透视）引导下球囊后凸成形术的性能。
2005年1月至2006年3月期间，根据两种不同方案进行了41例后凸成形术。研究组1由20例连续患者组成，他们接受了20次针对骨质疏松性或创伤性椎体骨折的双引导（CT扫描和透视）下球囊后凸成形术。研究组2由21例连续患者组成，他们仅在透视引导下进行了后凸成形术。对椎弓根的可视化、球囊最终位置和骨水泥分布进行评估（1-差，2-中等，3-好）。
CT和透视联合使用（组1）在识别椎弓根（100%对66.7%，p = 0.009）和球囊放置（100%对71.4%，p = 0.02）方面更具优势，但在监测椎体内骨水泥分布方面并非如此（100%对90.5%，p = 0.49）。两组之间的差异在胸椎比腰椎更明显。
后凸成形术的CT/透视引导结合了安全的CT引导下骨穿刺针和球囊的插入以及透视下聚甲基丙烯酸甲酯注射的实时监测。
