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

Abstract 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 spin...

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Main Authors: Shi Yin, Yan Zhang, Ying Du, Junxin Zou, Linfeng Zhou, Meilin Zhang, Zezhong Zeng, Zhiwei Jia, Zhendong Xu, Fangjun Zeng
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05824-x
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author Shi Yin
Yan Zhang
Ying Du
Junxin Zou
Linfeng Zhou
Meilin Zhang
Zezhong Zeng
Zhiwei Jia
Zhendong Xu
Fangjun Zeng
author_facet Shi Yin
Yan Zhang
Ying Du
Junxin Zou
Linfeng Zhou
Meilin Zhang
Zezhong Zeng
Zhiwei Jia
Zhendong Xu
Fangjun Zeng
author_sort Shi Yin
collection DOAJ
description Abstract 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 (Amax), the middle PIA (Amid), the minimum PIA (Amin), 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 Amid 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.
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spelling doaj-art-a6ea9a86bdda48b4bd2ddf5ca97114cb2025-08-20T02:28:41ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-04-0120111310.1186/s13018-025-05824-xAn imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approachShi Yin0Yan Zhang1Ying Du2Junxin Zou3Linfeng Zhou4Meilin Zhang5Zezhong Zeng6Zhiwei Jia7Zhendong Xu8Fangjun Zeng9Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Radiology, Affiliated Hospital of Guizhou Medical UniversityDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Radiology, Affiliated Hospital of Guizhou Medical UniversityDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Sports Medicine, Central Hospital of Dalian University of TechnologyDepartment of Spine Surgery, Ganzhou People’s HospitalAbstract 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 (Amax), the middle PIA (Amid), the minimum PIA (Amin), 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 Amid 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.https://doi.org/10.1186/s13018-025-05824-xPercutaneous vertebral augmentationOsteoporotic vertebral compression fractureThoracic spineUnilateral transverse process-pedicle approach
spellingShingle Shi Yin
Yan Zhang
Ying Du
Junxin Zou
Linfeng Zhou
Meilin Zhang
Zezhong Zeng
Zhiwei Jia
Zhendong Xu
Fangjun Zeng
An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
Journal of Orthopaedic Surgery and Research
Percutaneous vertebral augmentation
Osteoporotic vertebral compression fracture
Thoracic spine
Unilateral transverse process-pedicle approach
title An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
title_full An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
title_fullStr An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
title_full_unstemmed An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
title_short An imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process-pedicle approach
title_sort imaging anatomical study on percutaneous vertebral augmentation for thoracic spine via the unilateral transverse process pedicle approach
topic Percutaneous vertebral augmentation
Osteoporotic vertebral compression fracture
Thoracic spine
Unilateral transverse process-pedicle approach
url https://doi.org/10.1186/s13018-025-05824-x
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