Open AccessC-arm Fluoroscopic Cone Beam CT for Guidance of Minimally Invasive Spine Interventions
Author(s) -
Michael F. Powell
Publication year - 2010
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2010/13/51
Subject(s) - medicine , fluoroscopy , radiology , cone beam computed tomography , biplane , interventional radiology , percutaneous , interventional neuroradiology , computed tomography , engineering , aerospace engineering
Background: Isocentric C-arm fluoroscopic cone beam CT (CBCT) is a new technique fornear real time 3-D volume imaging guidance of percutaneous interventional procedures. Incombination with digital flat panel detectors, CBCT has high spatial resolution with isotropicvoxel size, allowing for high resolution image reconstruction in any plane, including 3D rotationalreconstructions. CBCT combines the advantages of conventional CT imaging guidance withthe improved spatial resolution, patient positioning, and access of fluoroscopy.Objective: The aim of this study is to demonstrate the advantages of CBCT over conventionalCT and biplane fluoroscopy for imaging guidance of minimally invasive spinal and paraspinalinterventional procedures.Methods: Five patients referred to the department of interventional neuroradiology forpercutaneous spinal or paraspinal interventional procedures were intraoperatively evaluatedwith CBCT to assist in guidance of instrumentation placement. Procedures included transoralcervical vertebral biopsy, percutaneous thoracic vertebral biopsy, vertebroplasty, pelvicparaspinal/epidural abscess drainage, and paraspinal fiducial marker placement for treatmentof osteoid osteoma.Results: All procedures were successfully performed with satisfactory diagnostic yield ortherapeutic effect without procedure-related complications.Conclusion: Isocentric C-arm fluoroscopic cone beam CT (CBCT) is a new technique for3D volume imaging guidance of interventional procedures of the spine with the capabilityto produce near real time high resolution image reconstructions in any plane. Compared toconventional CT and biplane fluoroscopy, CBCT offers improved anatomic visualization allowinghigh accuracy instrumentation placement, improving procedure results and minimizing risk ofcomplications.Key words: Vertebroplasty, kyphoplasty, biopsy, computed tomography, CT, fluoroscopy, Carm, percutaneous, interventional radiology, imaging guidance