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使用图像引导进行经口C1侧块椎体成形术。

Transoral vertebroplasty of the lateral mass of C1 using image guidance.

作者信息

Kavakebi Pujan, Girod P P, Hartmann S, Tschugg A, Thomé C

机构信息

Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

出版信息

Acta Neurochir (Wien). 2017 Jun;159(6):1159-1162. doi: 10.1007/s00701-017-3158-4. Epub 2017 Apr 3.

DOI:10.1007/s00701-017-3158-4
PMID:28374147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5425509/
Abstract

BACKGROUND

Osteolytic lesions of the anterior aspects of C1 (lateral mass) are difficult to address in a minimally invasive fashion and are often treated by craniocervical instrumentation.

METHODS

We report the feasibility and technical method of transoral vertebroplasty of the lateral mass of the atlas using image guidance and describe the workflow of the procedure. To our knowledge, there has not yet been a technical description of a transoral vertebroplasty using image guidance.

RESULTS

Adequate positioning of the pedicle access needle using image guidance for addressing the lateral mass of C1 through a transoral, permuceous access can be achieved.

CONCLUSIONS

With the assistance of image guidance, it is safe and feasible to access the lateral mass of the atlas. This constitutes a minimally invasive and fast alternative for introducing the bone needle to C1 rather than using a fluoroscopic device alone.

摘要

背景

第一颈椎（侧块）前方的溶骨性病变难以采用微创方式处理，常通过颅颈固定器械进行治疗。

方法

我们报告了使用影像引导经口对寰椎侧块进行椎体成形术的可行性和技术方法，并描述了该手术的操作流程。据我们所知，尚未有关于使用影像引导经口椎体成形术的技术描述。

结果

通过影像引导，经口黏膜入路处理第一颈椎侧块时，可实现椎弓根穿刺针的充分定位。

结论

在影像引导的辅助下，进入寰椎侧块是安全可行的。这为将骨针引入第一颈椎提供了一种微创且快速的替代方法，而非仅使用荧光透视设备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/26c8fa053d0b/701_2017_3158_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/e7e526f542ca/701_2017_3158_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/8093362b4196/701_2017_3158_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/3c2c661ff298/701_2017_3158_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/26c8fa053d0b/701_2017_3158_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/e7e526f542ca/701_2017_3158_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/8093362b4196/701_2017_3158_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/3c2c661ff298/701_2017_3158_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93ed/5425509/26c8fa053d0b/701_2017_3158_Fig4_HTML.jpg

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本文引用的文献

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Spine (Phila Pa 1976). 2013 Feb 1;38(3):E193-7. doi: 10.1097/BRS.0b013e31827d41c7.
2
Tumours of the atlas and axis: a 37-year experience with diagnosis and management.寰枢椎肿瘤：37 年诊断和治疗经验。
Radiol Med. 2012 Jun;117(4):616-35. doi: 10.1007/s11547-011-0753-y. Epub 2011 Nov 17.
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Anterolateral percutaneous vertebroplasty at C2 for lung cancer metastasis and upper cervical facet joint block.
经皮C2椎体前外侧成形术治疗肺癌转移及上颈椎小关节阻滞。
Clin J Pain. 2008 Sep;24(7):641-6. doi: 10.1097/AJP.0b013e31816c6630.
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Surgical approaches: postoperative care and complications "transoral-transpalatopharyngeal approach to the craniocervical junction".手术入路：术后护理及并发症“经口-经腭咽入路至颅颈交界区”
Childs Nerv Syst. 2008 Oct;24(10):1187-93. doi: 10.1007/s00381-008-0599-3. Epub 2008 Apr 4.
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Minimally invasive treatment of C2 odontoid traumatic fracture with transoral percutaneous vertebroplasty.经口经皮椎体成形术微创治疗C2齿状突创伤性骨折
Eur Radiol. 2007 Mar;17(3):850-1. doi: 10.1007/s00330-006-0283-5. Epub 2006 Apr 27.
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