The Research Of Puncturing Angles And Points In Percutaneous Vertebroplasty

Objective:To explore the puncturing angles and points through the transpedicular approach in percutaneous vertebroplasty in order to get its safe and effective procedure;To research a accurate puncturing procedure under the fluoroscopic unit for the thoracolumbar vertebraes.Methods:1.Collect the CT images of 96 normal thoracolumbar vertebraes which are often destroyed in osteoporotic vertebral compression fracture,and select the most generous level of each vertebra's CT images;2.The possible range of puncturing points and angles and the vertebra parameters will be measured by the computer,the puncture distance to posterior midline will be reformed;3.The statistical analyses will be made to research the differences between two sides dataes,the differences in these different vertebras and the correlation between the vertebra shape and the puncturing approach.Results:1.The dataes of puncturing angle and point have a increasedly overall trend from T10 to L5, including a slight decrease from T10 to T11,then gradually increased until L5.2.Punctruing through the Transpedicular approach in percutaneous vertebroplasty,there was a significant difference in the different thoracolumbar vertebras.3.There was a linear relationship between the puncturing angles and the pedicle lateral distance, the vertebral level,the sagittal diameter of vertebral body,among which the pedicle lateral distance make a most significant impact,followed by the vertebral level,and the sagittal diameter of vertebral body make a leatest impact.There was a positive correlation between the puncturing angles and the pedicle lateral distance,the vertebral level,also there was a negative correlation between the puncturing angles and the sagittal diameter of vertebral body. Conclusion:1.To the thoracolumbar vertebraes,Puncturing through the Transpedicular approach can reach a satisfied position in the vertebra body.2.There was a different puncturing procedure in each thoracolumbar vertebrae,on the whole the best angle of puncture needle is 25°～30°to the sagittal plane,the best puncture point on the skin is 35mm～50mm to the posterior midline.3.Refered to the best puncture pathway,its change rules and the impact factors yield in this subject,the puncture procedure must be more rapid,safe and effective.