CT guidance - Procedural Steps
After CT targeting, the needle is positioned inside the vertebral body
After loco regional anesthesia a special kind of needle is placed in the vertebra. This procedure is carefully and precisely obtained under CT and/or fluoroscopy guidance. Once the needle is properly positioned in the vertebra a few ml of Bone Cement (PMMA) are injected evaluating, under fluoroscopy control, the presence of unwanted leakage. In some cases to obtain a better vertebral consolidation is possible to perform a bilateral approach.
After CT guidance targeting (small steel balls are placed on the skin) a locoregional anesthesia is made by means of fine needles (22G). Then the vertebroplasty needles (from 15 to 11G) is placed and a few ml of Cement are injected. All the procedure is realtime monitored under fluoroscopy.
Percutaneous Vertebroplasty in most cases is usually performed under Digital Fluoroscopy in an Angiographic operating room.
Dependently of the vertebral column district 3 different percutaneous approaches are used:
Anterolateral (cervical vertebra)
Intercostovertebral (thoracic vertebra)
Transpeduncolar (lumbar vertebra)