Vertebroplasty

1. Before surgery, it is necessary to improve the DR film, local CT, magnetic resonance imaging, and bring the imaging film into the operating room.

2. Before surgery, it is necessary to fully analyze the position of the responsible vertebral body and locate it using the adjacent deformed vertebral body, the highest point of the iliac crest, and the twelfth rib.

3. If the C-arm machine in the operating room cannot clearly display the vertebral body, it is necessary to resolutely go to the DR room for surgery without hesitation.

4. Analyze the angle, depth, and distance of the midline of the puncture through CT before surgery.

5. When pushing bone cement, it is important to carefully observe the piece. If there is any leakage, it should be stopped in a timely manner. Safety is the top priority. The amount of bone cement pushed should be determined, and there is no need to force the piece to look good. A small amount of bone cement can also have a good effect.

6. Once poor puncture results are found during surgery, do not pursue bilateral puncture. It is also good to perform on one side, safety first.

7. Leakage within the pedicle (needle passage) is related to iatrogenic procedures, which occur when the bone cement is not fully injected into the vertebral body through the push rod. It is related to the failure to rotate or replace the empty push rod before the bone cement solidifies.

8. The puncture angle can be up to 15 degrees. When the patient complains of lower limb numbness during puncture, the puncture needle may enter the spinal canal or stimulate the nerve root by the lower edge of the pedicle, so the angle must be adjusted.

9. When puncturing the pedicle of the vertebral arch, there is a feeling of emptiness, which may enter the spinal canal. It is necessary to adjust the puncture angle through a C-arm machine.

10. Don't be anxious or irritable during surgery, and do each step calmly.

11. When removing the needle, wait for the bone cement to solidify slightly, as it is easy to remove the bone cement too early and leave it on the needle passage; It is difficult to remove the needle too late, usually around 3 minutes after the injection is completed. When removing the needle, the needle core should be installed properly to avoid leaving residual bone cement in the needle passage. The needle should be slowly removed using a rotating method.

12. If the patient is taking anticoagulants such as warfarin, aspirin, and hydrocclopidogrel with low platelet count, special attention should be paid during surgery, as improper puncture may cause intraspinal hematoma.