An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach

• Published in: Journal of orthopaedic surgery and research Vol. 20; no. 1; pp. 414 - 13
• Main Authors: Yin, Shi, Zhang, Yan, Du, Ying, Zou, Junxin, Zhou, Linfeng, Zhang, Meilin, Zeng, Zezhong, Jia, Zhiwei, Xu, Zhendong, Zeng, Fangjun
• Format: Journal Article
• Language: English
• Published: London BioMed Central 24.04.2025; BioMed Central Ltd; BMC
• Subjects: Aged; Aged, 80 and over; CT imaging; Diagnostic imaging; Female; Fractures, Compression - diagnostic imaging; Fractures, Compression - surgery; Humans; Imaging, Three-Dimensional - methods; Male; Medicine; Medicine & Public Health; Methods; Middle Aged; Orthopedics; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - surgery; Osteoporotic vertebral compression fracture; Percutaneous vertebral augmentation; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Surgical Orthopedics; Thoracic spine; Thoracic Vertebrae - anatomy & histology; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - surgery; Tomography, X-Ray Computed - methods; Unilateral transverse process-pedicle approach; Vertebroplasty - methods; Osteoporotic vertebral compression fracture; Unilateral transverse process-pedicle approach; Percutaneous vertebral augmentation; Thoracic spine
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-025-05824-x

Background Percutaneous vertebral augmentation (PVA) via the unilateral transverse process-pedicle approach (UTPPA) has shown promise for treating painful osteoporotic vertebral compression fractures (OVCFs). This study aimed to investigate the anatomical parameters of PVA for thoracic spine via the UTPPA using a three-dimensional computed tomography (3D CT) database. Methods PVA was simulated through the UTPPA on 3D CT scans on 100 patients (50 men and 50 women), involving a total of 1200 thoracic vertebral bodies (T1-T12). Anatomical parameters, including the distance between the bone entry puncture point and the midline of the vertebral body (DEM), the puncture inner inclination angle (PIA), the maximum PIA (A max ), the middle PIA (A mid ), the minimum PIA (A min ), the safe range of the PIA (SRA), and the minimum transverse pedicle width (MTPW), were measured and compared. Results The mean DEM ranged from 17.60 ± 2.63 mm to 22.71 ± 4.07 mm, and the A mid ranged from 24.27° ± 2.21° to 40.77° ± 6.11°. The mean left DEM was significantly larger than the right ( p  < 0.001). The right SRA was significantly larger than the left ( p  < 0.001). The mean DEM, SRA and MTPW were significantly larger in men than in women ( p  < 0.001). Conclusion In PVA for thoracic spine treatment using UTPPA, our study demonstrated that selecting this approach in men and puncturing from the right side in the thoracic vertebrae could be safer.