Objective
s: The authors have applied the percutanous vertebroplasty with a modified unilateral transpedicular approach ins- tead of the conventional bilateral transpedicular approach to the osteoporotic compression fracture patients. Clinical and radiological outcomes were analysed.
Methods
24 patients of unilateral transpedicular percutanous vertebroplasty were performed between January and December 2002. The target of needle direction in the unilateral transpedicular approach differed from bilateral transpedicular approach. In the lumbar region, the AP fluoroscopy tube is angled more laterally until the oval appearance of the pedicle is transformed into a "Scotty dog" appearance over the pedicle. In the thoracic regions, we empirically angle the tube to approximately 10-20°. The needle is advanced until it approaches the anterolateral wall of the contralateral half of the vertebra. The methods of cement mix and deposition is the same as the conventional bipedicular approach. Plain radiographs and CT on the injection site after procedure were obtained to confirm the location of injected bone cement. Clinical and radiological results before/ after procedure were analysed.
Results
Mean age was 71.20±6.01 years. The fractured level consisted of 17 at thoracic, 7 at lumbar levels. The filling across the midline was achieved in 21(87.5%) of 24 injections. Amount of injected cement was 2.87±0.33 cc and epidural and paravertebral leakage were observed in two(8.3%) patients but neurological deficit was not seen. 21(87.5%) of 24 patients had achieved excellent or good outcome at 12 months follow up.
Conclusion
The unilateral transpedicular approach has the advantages of good midline filling of cement, good results, short operation time in addition to pain relief for osteoporotic compressioin fracture patients.
