Vertebroplasty Utilizing Percutaneous Vertebral Body Access (PVBA) Technique for Osteoporotic Vertebral Compression Fractures in the Middle Thoracic Vertebrae

Cho, Yong Jun; Choi, Jong Hun; Cho, Sung Min

Abstract

OBJECTIVE
: Percutaneous approach to the middle thoracic vertebra through the transpedicular route for the patients with osteoporotic vertebral compression fractures is difficult due to the small size of the pedicle and parasagittally oriented vertebral body anatomy. The percutaneous vertebral body access (PVBA) technique utilizing the posterolateral extrapedicular approach avoids the pedicle and provides direct access to the vertebral body. The objective of this study is to evaluate the efficacy of the vertebroplasty utilizing PVBA technique for osteoporotic vertebral compression fractures in the middle thoracic vertebrae.
METHODS
: A retrospective review was done on 20 patients who underwent vertebroplasty utilizing PVBA technique performed for painful osteoporotic compression fracture in the middle thoracic vertebrae at 22 levels from May 2003 to June 2006. The average amount of the injected cement was 1.5-2.5ml. The postprocedural outcome was assessed using a visual analogue scale (VAS).
RESULTS
: The treated vertebrae were T5 (1 level), T6 (5 levels), T7 (7 levels), and T8 (9 levels). The compression rate and kyphotic angle were improved after procedure from 18%+/-13.4 to 16%+/-13.8 (p>0.05) and from 6.9degrees+/-6.7 to 6.6degrees+/-6.2 (p>0.05), respectively. Preprocedural VAS was 8.2+/-0.70 and was decreased to 2.1+/-1.02 (p<0.01) after treatment. Postprocedural cement leakage was noted in 3 levels (13.7%). There were no cases of leakage to epidural space or neural foramen, segmental artery injury, and pneumothorax.
CONCLUSION
: These results suggest that the complication rates are low and good results can be achieved with vertebroplasty utilizing PVBA technique for the osteoporotic vertebral compression fractures especially in the middle thoracic vertebrae.