Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.

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Comparison Between Percutaneous Kyphoplasty And Percutaneous Vertebroplasty In Terms of The Efficacy For Osteoporotic Vertebral Compression Fractures: A Meta-Analysis

10.21203/rs.3.rs-609136/v1 ◽

2021 ◽

Author(s):

Hai-Tao Zhu ◽

De-Gang Ding ◽

Shui Wang ◽

Yu-Long Zhu

Keyword(s):

Meta Analysis ◽

Operation Time ◽

The Elderly ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Beneficial Effects ◽

Radiographic Outcomes ◽

Vas Scores

Abstract Background & Aim: Osteoporotic vertebral compression fractures (OVCFs) are acknowledged as common occurred fractures among humans, especially for the elderly population. The minimally invasive percutaneous methods such as kyphoplasty as well as vertebroplasty have been valid and effective tools in terms of reducing clinical problems, which are associated with more beneficial effects as compared to traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence available for the systematical assessment of the clinical and radiographic outcomes of VP in comparison of KP.Methods: Publications on comparison kyphoplasty versus vertebroplasty in treatment of OVCFs were collected. After rigorous and thorough review of quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the endpoints of interested.Results: Totally, our inclusion criteria involved five studies. 561subjects involving 334 patients received VP and 227 patients received KP were included, of which patients receiving KP or VP failed to show any significant differences in the visual analog scale (VAS) scores (MD =-0.02, 95% CI -0.40 – 0.35; P = 0.91),and the risk of cement leakage (OR =1.60, 95% CI 0.82 – 3.12; P = 0.17). Nevertheless, the Oswestry Disability Index (ODI) scores (MD =-1.56, 95% CI -2.39 – -0.73; P = 0.0002), the injected cement volume (MD =-0.40, 95% CI -0.77 – -0.04; P = 0.03) and the operation time (MD =-9.67, 95% CI -11.55 – -7.80; P ＜0.00001) in VP group were linked to markedly lower trend in comparison of KP group with significant statistical difference.Conclusion: The present meta-analysis controls the acceptable level of the efficacy across the involved trials. The VP had ODI scores, the injected cement volume and the operation time exerted several advantages in this meta-analysis. Yet, VP failed to show benefits in terms of the VAS scores and cement leakage in comparison of KP therapy. Given the combined results of our study, the optimal treatment for patient harboring OVCFs should be determined by further high-quality and multi-center RCTs along with longer follow-ups as well as larger sample size.

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Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures

BMC Surgery ◽

10.1186/s12893-019-0653-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rui Zhong ◽

Jianheng Liu ◽

Runsheng Wang ◽

Yihao Liu ◽

Binbin Chen ◽

...

Keyword(s):

Compression Fracture ◽

Operation Time ◽

Cement Leakage ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Significant Difference ◽

Vas Scores ◽

Postoperative Improvement

Abstract Background Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP). Methods We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups. Results The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level. Conclusions Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.

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Unilateral Transforaminal Approach (UTFA) in Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Novel Puncture Technique

10.21203/rs.3.rs-154379/v1 ◽

2021 ◽

Author(s):

wang yefeng ◽

Li suoyuan ◽

Cai xiaoqiang ◽

Shen jun ◽

Zou tianming

Keyword(s):

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Vertebral Compression Fractures ◽

X Rays ◽

Osteoporotic Vertebral Compression Fractures ◽

Invasive Treatment ◽

X Ray ◽

Compression Fractures ◽

Transforaminal Approach

Abstract Background: Percutaneous vertebroplasty (PVP) via various puncture approaches was an effective minimally invasive treatment for osteoporotic vertebral compression fractures (OVCFs). In recent years, unilateral puncture techniques had been increasingly used with advantages of shorter operation time, lower X-ray exposure. The aim of this study was to explore the safety and efficacy of the unilateral transforaminal approach (UTFA) in PVP for the treatment of OVCFs. Methods: A retrospective study was designed to review 155 cases of single-level OVCFs from July 2018 to December 2019. We treated 77 patients with PVP via the UTFA and 78 via the bilateral transpedicular approach (BTPA). Operation time, number of intraoperative fluoroscopic X-rays, volume of bone cement injection and distribution of bone cement were recorded. We used Visual Analog Scale (VAS) score and Oswestry disability index (ODI) presurgery and at 1 day, 3 months and last follow-up after surgery to assess clinical outcomes. Results: The operation was successfully completed in both groups, with no complications of neurovascular injuries or bone cement embolism. UTFA group had significantly shorter operation time and less-frequent fluoroscopy than BTPA group (P < 0.05). There were no significant differences between the two groups in volume or distribution of injected bone cement (P > 0.05). Postoperative VAS scores and ODI of the two groups were significantly improved over their presurgical values (P < 0.05), but there were no significant differences in VAS or ODI at each time point between the two groups (P > 0.05). Conclusions: Both unilateral transforaminal PVP and bilateral transpedicular PVP were safe and effective treatments for OVCFs, but the former approach had the advantages of shorter operation time and less X-ray radiation exposure and therefore is worthy of greater clinical application.

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Comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures

10.21203/rs.3.rs-22865/v1 ◽

2020 ◽

Author(s):

Juan Long ◽

Chun Jing He ◽

Zikun Duan ◽

Xinguo Kang ◽

Jinfeng Zou

Keyword(s):

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Compression Fractures ◽

Needle Position ◽

Relieve Pain ◽

Group A ◽

Group B

Abstract BACKGROUND The purpose of this study was to comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures. METHODS Sixty-four severe vertebral compression fractures patients were treated in our hospital were randomly divided into group A and group B(n = 32). Group A received Percutaneous vertebroplasty (PVP) treatment by unilateral vertebral pedicle approach. Group B received PVP treatment by bilateral vertebralpedicle approach. Visual Analogue scale (VAS) score and Oswesty Disability Index (ODI) were recorded before surgery, and at 1d,1 month, and 6 months after operation. Also, the puncture path, needle position, intraoperative bone cement injection volume, bone cement dispersion, intra-operative and postoperative complications were observed. RESULTS Sixty-four vertebrae were successfully punctured.The postoperative VAS,ODI were lower than preoperative, showed statistical difference compared with the preoperative VAS, ODI, but there are no difference between Group A and Group B.The cement leakage and operation time is lower in group A than that in Group B. CONCLUSION PVP by unilateral vertebral pedicle approach in treating severe vertebral compression fractures can significantly relieve pain and promote functional recovery, which has advantages such as convenient operation and low complication rate.

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Comparison between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of posterior wall rupture and osteoporotic vertebral compression fractures-Case - based retrospective study

10.21203/rs.3.rs-19906/v1 ◽

2020 ◽

Author(s):

Yong-sheng Gou ◽

Yue Hu ◽

Hai-bo Li ◽

Bo-lin fu ◽

Zheng Che

Keyword(s):

Retrospective Study ◽

Clinical Efficacy ◽

Percutaneous Vertebroplasty ◽

Compression Fracture ◽

Operation Time ◽

Posterior Wall ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty

Abstract Background: Percutaneous kyphoplasty (PKP) or percutaneous vertebral plasty (PVP) has been widely applied in the treatment of osteoporotic vertebral compression fractures (osteoporotic vertebral compression will fracture, OVCF) because of its minimally invasive and effective. To compare the clinical efficacy and safety of percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures with posterior wall broken. Methods: 82 patients with osteoporotic vertebral compression fracture with posterior wall broken were divided into PVP group(group A) and PKP group(group B)．The operation time, perspective times, bone cement volume injected. cement leakage, hospitalization expenses, preoperative visual analog score(VAS) and Oswestry disability index(ODI), restoration height of vertebral, the vertebrae height loss and new fracture of adjacent vertebra were evaluated during the follow-up. Results: The PVP group incurred significantly shorter operation time(40.37 ±8.26 min) and less perspective times (22.23 ±3.79 times)than the PKP group(46.74 ±9.58 min and 27.96 ±5.71 times respectively)( P<0.05). The PVP group incurred significantly less expenses than the PKP group(P<0.05). The VAS scores and ODI at 1 day and 6 months post-operation were significantly lower than pre-operation in both groups(P<0.05). Conclusion: Both PVP and PKP Can obtain satisfactory clinical efficacy for the treatment of osteoporotic vertebral compression fractures with posterior wall broken,but the former may have advantages of less expenses,shorter operation time. Trial registration: This retrospective study was approved by the ethics committee of the first people's hospital of shuangliu district, Chengdu, Moreover, this study was also registered in the Chinese clinical trial registry with the registration number of ChiCTR1900028176.

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The Comparison of Ultrasound and Fluoroscopy-guided for Determining Puncture Entry Point of Percutaneous Vertebroplasty

10.21203/rs.3.rs-149179/v1 ◽

2021 ◽

Author(s):

Sen Ye ◽

Xiaorong Lai ◽

Lingjian Zhong ◽

Changzhang Yu ◽

Yanzhen Chen

Keyword(s):

Success Rate ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Entry Point ◽

Vertebral Compression Fractures ◽

Ultrasound Guided ◽

Significant Difference ◽

Fracture Nonunion ◽

Vas Scores ◽

The One

Abstract OBJECTIVE: The purpose of this study was to compare the safety and efficacy of ultrasound and fluoroscopy-guided for determining the puncture entry point of percutaneous vertebroplasty (PVP). Methods: From November 2018 to December 2019, a total of 50 eligible patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) treated by PVP were retrospectively collected, of which 25 cases were in ultrasound-guided group and the other 25 cases were in fluoroscopy-guided group. Radiation doses, one-time localization success rate, operation time, clinical efficacy and complications incidence were compared between the two groups. Results: Ultimately, 46 patients completed followed-up, whose average follow-up time was 9 months, the dose and times of fluoroscopy and operation time in ultrasound-guided group statically significantly decreased compared with fluoroscopy-guided group (P<0.01). The one-time localization success rate in ultrasound-guided group and fluoroscopy-guided group were 68.2% and 37.5% respectively ( x 2 = 4.33, P=0.037), whose difference was statistically significant (P<0.01). However, there was no significant difference in the visual analog scale (VAS) scores of back pain relief between the two groups (P>0.05). There were no postoperative complications such as infection, hematoma formation and fracture nonunion observed between the two groups.Conclusion: Ultrasound-guided entry point determination for PVP puncture is safe, which can significantly improve the success rate of one-time localization and decrease radiation exposure and operation time.

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Effect of 3D-Printed Hearts Used in Left Ventricular Outflow Tract Obstruction: A Multicenter Study

10.21203/rs.3.rs-1206928/v1 ◽

2022 ◽

Author(s):

Xianzhi Wang ◽

Jixiang Liang ◽

Cunfu Mu ◽

Wenlin Zhang ◽

Chunzhu Xue ◽

...

Keyword(s):

Left Ventricular Outflow Tract ◽

Operation Time ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Outflow Tract ◽

Control Group ◽

Intraoperative Blood Loss ◽

Left Ventricular Outflow ◽

3D Printed ◽

Experimental Group

Abstract Objective:The purpose of this research was to explore the application value of a three-dimensional (3D)-printed heart in the operation for left ventricular outflow tract (LVOT) obstruction. Methods: From August 2019 to October 2021, 46 patients with LVOT obstruction underwent surgical treatment at Peking University International Hospital, Southwest Medical University Affiliated Hospital of Traditional Chinese Medicine and Guangyuan First People's Hospital. According to the treatment method, 22 cases were allocated to the experimental group and 24 cases to the control group . The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, postoperative ejection fraction (EF), left ventricular flow velocity (LVFV), LVOT pressure difference (LVP), postoperative interventricular septal thickness (IST), inner diameter of the left ventricular outflow tract (IDLV), systolic anterior motion (SAM), atrioventricular block rate, aortic regurgitation (AR) rate and surgical complication rate of the two groups were compared. Results: The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, LVP, postoperative IST, AR, SAM, and postoperative LVFV of the experimental group were significantly lower than those of the control group (P < 0.05). The IDLV was larger than that of the control group (P < 0.05). There was no significant difference in the postoperative EF, atrioventricular block rate or complication rate between the two groups (P > 0.05). Conclusion: A 3D-printed heart model for in vitro simulation surgery is conducive to formulating a more reasonable surgical plan and reducing surgical trauma and operation time, thereby promoting the recovery and maintenance of the heart.

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The Comparation of Ultrasound and Fluoroscopy-guided for Determining Puncture Entry Point of Percutaneous Vertebroplasty

10.21203/rs.3.rs-44122/v1 ◽

2020 ◽

Author(s):

Sen Ye ◽

Xiaorong Lai ◽

Lingjian Zhong ◽

Changzhang Yu ◽

Wen Lu ◽

...

Keyword(s):

Success Rate ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Entry Point ◽

Vertebral Compression Fractures ◽

Ultrasound Guided ◽

Significant Difference ◽

Fracture Nonunion ◽

Vas Scores ◽

The One

Abstract Objective: The purpose of this study was to compare the safety and efficacy of ultrasound and fluoroscopy-guided for determining the puncture entry point of percutaneous vertebroplasty (PVP). Methods: From November 2018 to December 2019, a total of 50 eligible patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) treated by PVP were retrospectively collected, of which 25 cases were in ultrasound-guided group and the other 25 cases were in fluoroscopy-guided group. Radiation doses, one-time localization success rate, operation time, clinical efficacy and complications incidence were compared between the two groups.Results: Ultimately, 46 patients completed followed-up, whose average follow-up time was 9 months, the dose and times of fluoroscopy and operation time in ultrasound-guided group statically significantly decreased compared to fluoroscopy-guided group (P<0.01). The one-time localization success rate in ultrasound-guided group and fluoroscopy-guided group were 68.2% and 37.5% respectively (x2= 4.33, P=0.037), whose difference was statistically significant (P<0.01). However, there was no significant difference in the visual analog scale (VAS) scores of back pain relief between the two groups (P>0.05). There were no postoperative complications such as infection, hematoma formation and fracture nonunion obsereved between the two groups.Conclusion: Ultrasound-guided entry point determination for PVP puncture is safe, which can significantly improve the success rate of one-time localization and decrease radiation exposure and operation time.

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Precise Puncture Combined With Simplified Percutaneous Vertebroplasty to Treat Osteoporotic Vertebral Compression Fractures: A Comparative Analysis With Conventional Percutaneous Vertebroplasty

10.21203/rs.3.rs-101497/v1 ◽

2020 ◽

Author(s):

Ju-tao Pang ◽

Hong Chen ◽

Bin Liu ◽

Xin-hu Zhang

Keyword(s):

Bone Cement ◽

Operative Time ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Intraoperative Fluoroscopy ◽

Group A ◽

Group B

Abstract ObjectiveThis study aimed to investigate the feasibility and clinical efficacy of precise puncture combined with simplified percutaneous vertebroplasty (PVP) for treating osteoporotic vertebral compression fractures (OVCF).MethodsA total of 82 patients with single-segment osteoporotic vertebral compression fractures (OVCF) were treated with PVP from Dec. 2016 to Nov. 2018. Among the patients, 45 cases in group A and accepted precise puncture combined with simplified PVP, 37 cases in group B and underwent conventional PVP. The operative time, number of intraoperative fluoroscopy, vertebral height restoration, postoperative bone cement distribution and bone cement leakage were observed and compared. The pain relief and improvement of quality of life (QOL) were assessed by visual analog score (VAS) and Oswestry disability index (ODI).ResultsThere were no difference in injected cement volume and hospital stays in group A versus group B (P > 0.05). The operative time, number of intraoperative fluoroscopy and material cost were lower in group A compared with group B (P < 0.05). After surgery, both of the VAS scores and ODI had a significant decrease (P < 0.05). The average vertebral height and Cobb angle were significantly improved (P < 0.05), there was no statistically significant difference between groups at different time points (P > 0.05). The proportion of patients with bone cement dispersion exceeding the midline of vertebra in group A was significantly higher than that in group B (82.2% vs 62.1%) (P < 0.05), whereas the bone cement leakage rate was lower than group B (8.9% vs 27.0%) (P < 0.05). Patients were followed-up for 12-23 months (mean 17.6 months) after surgery, and 3 cases (6.6%) of adjacent vertebral fractures occurred in group A and 2 cases (5.4%) occurred in group B (P > 0.05).ConclusionPrecise puncture can improve the accuracy of puncture needle through pedicle to vertebral body. It conducive to obtain a better diffusion of bone cement across the midline with lower bone cement leakage rate. Simplified PVP can reduce the surgery procedures, shorten the operatige time, reduces the X-ray frequency, but also saves material cost.

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Application of 3D-Printed Personalized Guide in Arthroscopic Ankle Arthrodesis

BioMed Research International ◽

10.1155/2018/3531293 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Xiaojun Duan ◽

Peng He ◽

Huaquan Fan ◽

Chengchang Zhang ◽

Fuyou Wang ◽

...

Keyword(s):

Kirschner Wire ◽

Operation Time ◽

Ankle Arthrodesis ◽

Control Group ◽

Kirschner Wires ◽

Correct Position ◽

Intraoperative Radiation ◽

3D Printed ◽

The Times ◽

Experimental Group

Objective. To accurately drill the Kirschner wire with the help of the 3D-printed personalized guide and to evaluate the feasibility of the 3D technology as well as the outcome of the surgery. Methods. Patients’ DICM data of ankle via CT examinations were introduced into the MIMICS software to design the personalized guides. Two 2mm Kirschner wires were drilled with the help of the guides; the C-arm fluoroscopy was used to confirm the position of the wires before applying the cannulated screws. The patients who underwent ankle arthrodesis were divided into two groups. The experimental group adopted the 3D-printed personalized guides, while the control group received traditional method, i.e., drilling the Kirschner wires according to the surgeon’s previous experience. The times of completing drilling the Kirschner wires to correct position were compared between the two groups. Regular follow-ups were conducted to statistically analyze the differences in the ankle fusion time and AOFAS scores between the two groups. Results. 3D-printed personalized guides were successfully prepared. A total of 29 patients were enrolled, 15 in the experimental group and 14 in the control group. It took 2.2 ± 0.8 minutes to drill the Kirschner wires to correct position in the experimental group and 4.5 ± 1.6 minutes in the control group (p=0.001). No obvious complications occurred in the two groups during and after surgery. Postoperative radiographs confirmed bony fusion in all cases. There were no significant differences in the fusion time (p=0.82) and AOFAS scores at 1 year postoperatively between the two groups (p=0.55). Conclusions. The application of 3D-printed personalized guide in assisting the accurate drilling of Kirschner wire in ankle arthrodesis can shorten the operation time and reduce the intraoperative radiation. This technique does not affect the surgical outcome. Trial Registration Number. This study is registered on www.clinicaltrials.gov with NCT03626935.

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