CT-gesteuerte Sakroplastie unter Verwendung insufflierbarer Ballons. Ergebnisse einer Machbarkeitstudie

TY - JOUR

T1 - CT-gesteuerte Sakroplastie unter Verwendung insufflierbarer Ballons. Ergebnisse einer Machbarkeitstudie

AU - Briem, D

AU - Grossterlinden, L

AU - Begemann, P G

AU - Lehmann, W

AU - Rupprecht, M

AU - Nüchtern, J

AU - Barvencik, F

AU - Schumacher, U

AU - Rueger, J M

PY - 2008/6

Y1 - 2008/6

N2 - OBJECTIVE: The procedure of sacroplasty was introduced recently and involves the percutaneous application of cement to the sacral bone. Currently there are no standardized data available reflecting clinical results such as leakage rates or other complications. The aim of this study was to evaluate the feasibility and results of a balloon-assisted, CT-guided cement application in a controlled experimental approach.MATERIAL AND METHODS: The trials were conducted on preserved human cadaveric specimens (n=6). The cement application was supported by kyphoplasty balloons (Kyphon) on the right hand side, and was performed without balloons on the opposite side. CT scans were obtained for preoperative planning and postoperative assessment, while CT fluoroscopy was used for intraoperative guidance (Philips Brilliance 64).RESULTS: The procedure revealed a good feasibility with an average procedure time of 36.9+/-2.4 min (range 33.1-38.9). The chosen scan protocol produced the following effective doses: 0.99 mSv in females and 0.63 mSv in males per scan and 0.33 mSv (females) and 0.25 mSv (males) per CT fluoroscopy image. Extraosseous cement spreading was not observed after both balloon-assisted and conventional application.CONCLUSION: The CT-guided technique presented in this study enables surgeons to perform sacroplasty with high precision and moderate radiation exposure. Further clinical studies are necessary to show if the balloon-assisted cement application can promote lower leakage rates than the conventional technique in patients with sacral fractures.

AB - OBJECTIVE: The procedure of sacroplasty was introduced recently and involves the percutaneous application of cement to the sacral bone. Currently there are no standardized data available reflecting clinical results such as leakage rates or other complications. The aim of this study was to evaluate the feasibility and results of a balloon-assisted, CT-guided cement application in a controlled experimental approach.MATERIAL AND METHODS: The trials were conducted on preserved human cadaveric specimens (n=6). The cement application was supported by kyphoplasty balloons (Kyphon) on the right hand side, and was performed without balloons on the opposite side. CT scans were obtained for preoperative planning and postoperative assessment, while CT fluoroscopy was used for intraoperative guidance (Philips Brilliance 64).RESULTS: The procedure revealed a good feasibility with an average procedure time of 36.9+/-2.4 min (range 33.1-38.9). The chosen scan protocol produced the following effective doses: 0.99 mSv in females and 0.63 mSv in males per scan and 0.33 mSv (females) and 0.25 mSv (males) per CT fluoroscopy image. Extraosseous cement spreading was not observed after both balloon-assisted and conventional application.CONCLUSION: The CT-guided technique presented in this study enables surgeons to perform sacroplasty with high precision and moderate radiation exposure. Further clinical studies are necessary to show if the balloon-assisted cement application can promote lower leakage rates than the conventional technique in patients with sacral fractures.

KW - Bone Cements

KW - Catheterization

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Male

KW - Pilot Projects

KW - Radiography, Interventional

KW - Sacrum

KW - Spine

KW - Tomography, X-Ray Computed

KW - Vertebroplasty

KW - Evaluation Studies

KW - Journal Article

U2 - 10.1007/s00113-008-1432-x

DO - 10.1007/s00113-008-1432-x

M3 - SCORING: Zeitschriftenaufsatz

C2 - 18351311

VL - 111

SP - 381

EP - 386

JO - UNFALLCHIRURGIE

JF - UNFALLCHIRURGIE

SN - 0177-5537

IS - 6

ER -