Tomografia computadorizada combinada à técnica de fluoroscopia para procedimentos percutaneous complexos da coluna vertebral / Combined cone beam computed tomography and fluoroscopy techniques for challenging percutaneous spine procedures

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.