How is the C-arm machine used in bone cementing (PKP operation record)

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Percutaneous Kyphoplasty (PKP for short) is a common orthopedic procedure that can provide rapid recovery for patients with vertebral compression fractures. Because the operation is similar to “concrete grouting to strengthen the damaged part”, it is vividly called “bone cementing”.

Bone cement is usually performed with the help of a C-arm machine. How is it used? The following is an in-depth study through a surgical case in the Second Affiliated Hospital of Nanjing Medical University.

The patient suffered from a lumbar compression fracture, and after consultation with a doctor, he underwent bone cement fixation under a C-arm machine. The principle is similar to the perfusion technology of architecture. The puncture needle is used to accurately align the middle and upper ends of the collapsed vertebral body under perspective, and the bone cement is injected into the fractured vertebral body. After solidification, it can support and fix the fractured vertebrae, so that the fractured vertebrae can be restored. Stabilize so that the pain lessens or disappears and prevents further collapse of the fractured vertebra.

How to use the C-arm machine in bone cement

PKP surgery records:

(1) The patient is in the prone position, and then use the flexible positioning of the Puai large flat-panel C-arm machine to quickly locate the position of the pedicle and determine the needle entry point. The surgical area is routinely disinfected and sterile towels are spread, and anesthetics are placed at the positioning position Administer local anesthesia;

(2) The incision was 5 mm, and the direction and depth of needle insertion were determined with the help of high-definition images of the large-view flat panel C-arm machine PLX119C. A catheter is inserted through the pedicle into the vertebral body, a channel is created, and a bone expander (balloon) is inserted. Balloon dilation restores the height of the vertebral body, and forms a cavity in the vertebral body. The injection dose of bone cement is determined, and the bone cement is injected to observe its diffusion.

HD image of large flatbed C-arm machine

(3) C-arm fluoroscopy is required to check the distribution of bone cement during the injection process, so as to prevent nerve damage caused by the exposure of bone cement into the spinal canal. After the bone cement filling in the vertebrae is complete, the working sleeve is pulled out and pressed to stop the bleeding, and the prone position is continued for ten minutes, waiting for the bone cement to harden, and finally the operation is successfully completed.

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