Umebayashi Daisuke, Yamamoto Yu, Nakajima Yasuhiro, Hara Masahito
Department of Neurosurgery, Inazawa Municipal Hospital.
Neurol Med Chir (Tokyo). 2017 Sep 15;57(9):489-495. doi: 10.2176/nmc.tn.2016-0298. Epub 2017 Jun 28.
Percutaneous balloon kyphoplasty (PBKP) is generally performed under two-dimensional (2D) radiography guidance (lateral- and anteroposterior (A-P) views) using C-arm fluoroscopy. However, 2D images taken by single-plane or bi-plane fluoroscopy cannot provide information regarding axial views, particularly the Z axis. Lack of information regarding the Z axis prevents the creation of three-dimensional (3D) images. Currently, there has been a progress in interventional X-ray systems, and they are capable of providing 3D radiographic images using a rotational angiography mode which is used to create 3D angiographies. In this report, we described the usefulness of 3D radiography guidance. Patients treated by PBKP was designed to evaluate the efficacy of 3D radiography guidance. These patients experienced osteoporotic vertebral fractures with severe pain. We retrospectively analyzed patients who underwent PBKP from February to December 2016. All patients had a single-level vertebral fracture and underwent surgery by 2D or 3D radiography guidance. We performed 16 patients in 3D radiography guidance, and 10 patients in traditional 2D radiography guidance. This 3D radiography guided PBKP increase the amount of the polymethyl methacrylate (PMMA) injection compared with ordinary 2D method. As a result, postoperative vertebral height and alignment were significantly improved. Both groups have no complication. To confirm the final results and make PBKP more effective, 3D radiography guidance is feasible and safe for balloon kyphoplasty.
经皮球囊椎体后凸成形术（PBKP）通常在二维（2D）放射照相引导下（侧位和前后位（A-P）视图）使用C形臂荧光透视进行。然而，单平面或双平面荧光透视获取的2D图像无法提供有关轴向视图的信息，尤其是Z轴。缺乏Z轴信息会妨碍三维（3D）图像的创建。目前，介入式X射线系统有了进展，它们能够使用用于创建3D血管造影的旋转血管造影模式提供3D射线图像。在本报告中，我们描述了3D射线照相引导的实用性。设计接受PBKP治疗的患者以评估3D射线照相引导的疗效。这些患者患有伴有严重疼痛的骨质疏松性椎体骨折。我们回顾性分析了2016年2月至12月接受PBKP的患者。所有患者均为单节段椎体骨折，并在2D或3D射线照相引导下接受手术。我们在3D射线照相引导下对16例患者进行了手术，在传统2D射线照相引导下对10例患者进行了手术。与普通2D方法相比，这种3D射线照相引导的PBKP增加了聚甲基丙烯酸甲酯（PMMA）的注射量。结果，术后椎体高度和对线情况得到了显著改善。两组均无并发症。为了确认最终结果并使PBKP更有效，3D射线照相引导对于球囊椎体后凸成形术是可行且安全的。
