ABSTRACT
O tratamento da dor do paciente oncológico necessita de um acesso multidisciplinar. Se considerarmos metastases ósseas, mielomamúltiplo e linfoma, os procedimentos percutâneos como a vertebroplastia podem gerar um alívio rápido da dor. Entretanto,a vertebroplastia percutânea deve ser colocada de maneira a não retardar o tratamento sistêmico ou outras modalidades detratamento. Neste artigo, descrevemos nossos 15 anos de experiência com a colaboração de uma equipe multidisciplinar, atravésde revisão da literatura e pontos especiais da vertebroplastia percutânea para fraturas tumorais da coluna vertebral...
The pain management in oncologic patients requires a multidisciplinary approach. Considering bone metastases, multiplemyeloma and lymphoma, percutaneous procedures like vertebroplasty can provide rapid pain relief. However, percutaneousvertebroplasty must be placed in order to not delay systemic therapy or other modalities of treatment. In this article, we describedour 15 years experience in collaborating with a multidisciplinary team, reviewing literature and special issues percutaneousvertebroplasty for spinal tumoral fractures...
Subject(s)
Humans , Multiple Myeloma , Neoplasm Metastasis , Spinal Fractures , VertebroplastyABSTRACT
Transpedicular approaches for spine procedures are currently employed in biopsies and vertebroplasties (VT), and frequentlyperformed with computed tomography (CT) or fluoroscopy for image guidance. The fluoroscopy is not always reliable in termsof visualization if the pedicle is very small or destroyed by osteolytic lesions. CT is more precise in these situations but needleprogression is not visualized in dynamic view. We describe 3 cases where the anatomic landmarks were not well visualized innormal fluoroscopy and transpedicular needle implantation was achieved with a combined C-arm cone beam CT acquisition(CBCT), known as XperCT, and fluoroscopic overlay guidance, namely XperGuide.