Schupfner, Rupert and Koniarikova, Katarina and Pfeifer, Christian and Grechenig, Peter and Bakota, Bore and Staresinic, Mario and Kerner, Michael Alexander and Mueller, Michael (2021) An anatomical study of transpedicular vs. extrapedicular approach for kyphoplasty and vertebroplasty in the thoracic spine. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 52. S63-S69. ISSN 0020-1383, 1879-0267
Full text not available from this repository. (Request a copy)Abstract
Introduction: Percutaneous vertebral augmentation is a common therapeutic approach for osteoporotic or osteolytic vertebral fractures. Due to the variable pedicle anatomy two different approaches, the transpedicular and the extrapedicular approach have been established. In particular, in the middle and upper thoracic spine, percutaneous procedures are challenging because of difficult visualisation of anatomical landmarks and a more unfavourable anatomy with smaller and differently orientated pedicles. Material and methods: In our cadaveric study we compared the transpedicular and the extrapedicular approach to the thoracic spine. In 26 cadaveric spine specimes, embalmed using Thiel's method, we placed a total of 486 trans- and extrapedicular K-wires through Jamshidi needles in the vertebral bodies T4 - T12 under fluoroscopy. A CT scan was then performed to verify the actual position of the K-wire. Malpositioning was defined as deviation from the planned approach or placement of the K-wire in the spinal canal or outside the vertebral body. Number and direction of malpositionings was recorded. Results: Malpositioning occurred in 68 of 468 K-wires. It was more frequent in the transpedicular (54) than in the extrapedicular (14) approach. Intraspinal malposition was seen more often in the transpedicular approach (n=36) especially in the upper and middle thoracic spine. Conclusion: In summary both approaches are relatively safe but in the upper and middle thoracic spine the risk of intraspinal malpositioning seems to be lower when using the extrapedicular approach. (C) 2021 Published by Elsevier Ltd.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PAINFUL OSTEOPOROTIC COMPRESSION; BALLOON KYPHOPLASTY; PERCUTANEOUS VERTEBROPLASTY; PEDICLE SCREWS; FRACTURES; Vertebroplasty; Kyphoplasty; Transpedicular approach; Extrapedicular approach; Thoracic spine |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Sep 2022 12:59 |
| Last Modified: | 13 Sep 2022 12:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47231 |
Actions (login required)
 |
View Item |
