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Title of Journal: Eur Spine J

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Abbravation: European Spine Journal

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Springer-Verlag

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10.1016/0022-4405(91)90007-e

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1432-0932

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Safety of fluoroscopy guided percutaneous access t

Authors: Jonathan A Clamp Edward J Bayley Firooz V Ebrahimi Nasir A Quraishi Bronek M Boszczyk
Publish Date: 2012/02/23
Volume: 21, Issue: 2, Pages: 207-211
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Abstract

Fluoroscopyguided percutaneous access to thoracic vertebrae is technically demanding due to the complex radiological anatomy and close proximity of the spinal cord major vessels and pleural cavity There is a trend towards computed tomography CT guidance due to a perceived reduction in the risk of spinal canal intrusion by instrumentation causing neurological injury Due to limited access to CT guidance there is a need for safe fluoroscopyguided percutaneous access to the thoracic spineA combined twosurgeon prospective case series of 444 procedures biopsy vertebroplasty or kyphoplasty covering all thoracic vertebral levels T1–T12 Clinical examination and routine observations were used to identify accessrelated complications including neurological vascular and visceral injury using physiological parametersPercutaneous access to the thoracic spine using fluoroscopic guidance is safe The crucial step of the protocol is not to advance the tool beyond the medial pedicle wall on the anterior–posterior projection until the tip of the instrument has reached the posterior vertebral cortex on the lateral projection

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