The clinical application of Cone Beam CT imaging technology in percutaneous vertebral plasty

Objective: To explore the application value of DSA C arm of the Cone Beam CT (CBCT) imaging in the percutaneous vertebral plasty (PVP) procedure. Methods: Relative clinical data of 35 patients with vertebral compression fractures and vertebral metastatic carcinoma who received percutaneous vertebral plasty under the guidance of CBCT in our center between January 2013 and July 2016 were retrospectively analyzed. The value and effect of CBCT in relation to postoperative bone cement filling were also evaluated. Results: All patients were treated by PVP with only one puncture under local anesthesia successfully. Immediate postoperative DSA X-ray showed that 9 cases had bone cement leakage (25.7%, 9/35), including type Ⅰ leakage(17.1%, 6/35) in 6 patients, and type Ⅱ leakage (8.6%, 3/35) in 3 patients. Immediate postoperative CBCT examination showed bone cement leakage in 13 patients (37.1%, 13/35), including 6 cases of type I leakage (17.1%, 6/35), and 7 cases of type Ⅱ leakage (20%, 7/35). The immediate CBCT after PVP demonstrated a better distribution of the bone cement than DSA X-ray image. Conclusions: CBCT in percutaneous vertebral plasty has important clinical value in detecting the leakage of bone cement immediately after PVP. Key words: Cone Beam Computed tomography; Percutaneous Vertebral plasty; Vertebral compression fractures; Vertebral tumor