Artikel
ISO-C 3D navigated kyphoplasty of vertebral compression fractures (VCF)
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Autoren
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S. Gödde
- Universitätsklinikum des Saarlandes, Orthopädische Universitäts- und Poliklinik, Homburg/Saar
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E.W. Fritsch
- Homburg/Saar
| Veröffentlicht: | 13. Juni 2005 |
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Gliederung
Text
Introduction
The study was conducted to evaluate safety, precision and efficacy of ISO-C 3D navigated kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures.
Patients and Methods
26 consecutive ISO-C 3D navigated kyphoplasty procedures (Siemens ISO-C 3D; iON System, Medtronic SNT) were performed in 16 patients (T11 - L4). Symptomatic levels were identified by correlation of clinical data with MRI findings. PMMA application was achieved by using a bilateral, transpedicular approach. Clinical and perioperative variables, radiographs and CT scans were recorded and analyzed to evaluate various parameters.
Results
Mean follow up was 11 months. Mean time for surgery was 52 minutes (range, 39 - 109 minutes). Pain (VAS, 0-100) was reduced significantly from 78 pre-op to 13 postoperatively. Mean vertebral hight measured in the center of the vertebral body increased from 63% to 84% of the normal value. Loss of correction was not seen during follow-up. All CT-scans showed intrapedicular position of the cannula during kyphoplasty, no pedicle perforations were detected. Complications: lateral cement extravasation in 2 vertebral bodies (8%) without clinical symptoms, no bleedings, no injuries to spinal or extraspinal tissues.
Conclusions
ISO-C 3D navigation enables precise and correct positioning of the cannula in kyphoplasty at thoracic and lumbar levels. The risk of pedicle perforation and injuries to spinal or extraspinal tissue is reduced. Kyphoplasty is associated with significant clinical improvement as well as increase of vertebral body height though complete reconstruction is rare. ISO-C 3D navigation is a helpful tool to make kyphoplasty safer.
