Surgical techniques for unilateral percutaneous vertebroplasty of high thoracic vertebrae determined by the shape of the ribs under X-ray fluoroscopyunder X-Ray Fluoroscopy

Background : Percutaneous vertebroplasty is a very common method for the treatment of thoracolumbar osteoporotic vertebral compression fractures. However, when it comes to cases of high thoracic vertebrae, there exist challenging difficulties such as the risk of high puncture ,a steep learning curve of the procedure and multiple complications.As a result, Many doctors are not confident or reluctant to perform percutaneous vertebroplasty on high thoracic vertebrae In order to solve the aforementioned challenges, this article elaborates on the surgical techniques for unilateral vertebroplasty for high thoracic vertebral compression fractures determined by the course of the ribs under X-ray fluoroscopy Purpose : Explore a safe and effective method of percutaneous vertebroplasty for high thoracic vertebrae, which can reduce bone cement leakage make the distribution of bone cement more uniform avoid complications such as intercostal nerve injury Materials and Methods : Retrospectively selected 28 patients (including 29 high thoracic vertebrae) , and all of them were treated with unilateral percutaneous vertebroplasty for high thoracic vertebrae determined by the course of the ribs under X-ray fluoroscopy Results : The hardness of all 29 fractured vertebrae was enhanced after the procedure. The pain of all patients was significantly relieved 24 hours after the procedure. 23 cases (79.31%) with type I and type II distribution of bone cement after the procedure. Only 1 patient (3.45%) had right intercostal pain, and 2 patients (6.90%) had bone cement leakage The complication incidence rate of the new procedure was much lower than traditional percutaneous vertebroplasty, and there were no occurrences of other serious complications. Conclusions : The high thoracic vertebroplasty designed according to the shape of the ribs under X-ray fluoroscopyhas a good therapeutic effect, with better distribution of bone cement, a lower incidence of postoperative complications and higher safety. It is worthy of clinical reference and application.