Application of Three-Dimensional Reconstruction Technique in Percutaneous Kyphoplasty
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v5i4.3124
Abstract
At present, the aging process of the population in China has been gradually accelerated, and the incidence of osteoporosis in patients with thoracolumbar fractures in China is also increasing year by year. With the increasing elderly, compression fractures caused by osteoporosis are one of the important factors of thoracolumbar fractures. Vertebral fractures are most common in the T12 vertebral body, L1 vertebral body, L2 vertebral body, etc. , and most patients have no obvious trauma or only mild trauma, such as sprains, bending down and other daily movements, which can easily lead to vertebral fractures. The treatment of vertebral fractures is divided into conservative or surgical treatment, which is generally performed according to the patient's condition (1). Although conservative treatment is relatively safe, it is difficult to achieve satisfactory clinical efficacy, limiting its clinical application. Surgical treatment has a significantly higher clinical outcome than conservative treatment, and has been widely used by surgeons for the treatment of vertebral compression fractures in the elderly (2). Surgical treatment mainly includes percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP), and both methods have the characteristics of easy operation, less trauma, and fewer complications. After PVP/PKP in patients with osteoporotic compression fractures of the vertebrae at T12 and L1 levels, increasing bone mineral density (BMD) of the adjacent lumbar spine increased vertebral strength and decreased the incidence of adjacent vertebral fractures, and PKP was superior to PVP in increasing BMD of the adjacent lumbar spine (5). PKP is superior to PVP in terms of the amount of injected cement, short-term pain relief, improvement of short-term and long-term kyphotic angles, and reduction of cement leakage rate (6). In clinical practice, there are many types of patients with thoracolumbar vertebral compression fractures caused by osteoporosis, with large individual differences, so it brings many problems for its diagnosis, evaluation, and treatment (7). Three-dimensional reconstruction technique is a new imaging technique developed in recent years. It combines CT, MRI, X-ray and other imaging techniques with computer image processing, so as to make the display of the internal structure of the vertebral body and the fracture line clearer and provide more intuitive image information for clinical surgery. This article reviews the application of three-dimensional reconstruction technique in PKP treatment before, after and data analysis.
Keywords
lumbar compression fracture; finite element; mimics software; three-dimensional reconstruction; percutaneous kyphoplasty
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[23]YAO J, DONG B, SUN J, et al. Accuracy and Reliability of Computer-aided Anatomical Measurements for Vertebral Body and Disc Based on Computed Tomography Scans. Orthop Surg. 2020 Aug;12(4):1182-1189.
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[26]YANG CJ, LIN CL, WANG CK, et al. Generative Adversarial Network (GAN) for Automatic Reconstruction of the 3D Spine Structure by Using Simulated Bi-Planar X-ray Images. Diagnostics (Basel). 2022 Apr 30;12(5):1121.
[27]ZAMBORSKY R, KILIAN M, JACKO P, et al. Perspectives of 3D printing technology in orthopaedic surgery. Bratisl Lek Listy. 2019;120(7):498-504.
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[29]FITZPATRICK X, FAYZULLIN A, WANG G, et al. Cells-in-Touch: 3D Printing in Reconstruction and Modelling of Microscopic Biological Geometries for Education and Future Research Applications. Bioengineering (Basel). 2023 Jun 5;10(6):687.
[2]LIU M, CHEN XT, DOU T, et al. Surgical treatment of back pain in patients with osteoporotic thoracolumbar vertebral compression fractures. Chongqing Medicine 2017; 46: 2419–2421, 2430 [In Chinese].
[3]HINDE K., MAINGARD J., HIRSCH J. A., et al. Mortality outcomes of vertebral augmentation (vertebroplasty and/or balloon kyphoplasty) for osteoporotic vertebral compression fractures: a systematic review and meta-analysis. Radiology. 2020 Apr;295(1):96–103.
[4]NORIEGA D., MACIA S., THEUMANN N., et al. A prospective, international, randomized, noninferiority study comparing an implantable titanium vertebral augmentation device versus balloon kyphoplasty in the reduction of vertebral compression fractures (SAKOS study) The Spine Journal. 2019 Nov;19(11):1782–1795.
[5]Zhang C, Zhu K, Zhou J, et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013;27(7):819-823.
[6]Wang H, Sribastav SS, Ye F, et al. Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures: A Meta-analysis of the Literature. Pain Physician. 2015;18(3):209-222.
[7]COMPSTON JE, MCCLUNG MR, LESLIE WD. Osteoporosis. Lancet. 2019;393(10169):364–376.
[8]Wang Jiao, Liu Yang, Zhang Xiaoling, etc Application of Mimics software in 3D reconstruction of medical images [J].Chinese Medical Equipment Journal,2015,36(02):115-118.
[9]Wang Gui, Zhang Zhi, Zhang Liang, etc Application and Experience of Mimics Digital Software in Clinical Orthopedic Teaching Work [J]. China Medical Education Technology,2014,28(05):527-529.
[10]HU X.-J., WANG H. Biomechanical assessment and 3D finite element analysis of the treatment of tibial fractures using minimally invasive percutaneous plates. Experimental and Therapeutic Medicine. 2017;14(2):1692–1698.
[11]WAN S, XUE B, XIONG Y. Three-Dimensional Biomechanical Finite Element Analysis of Lumbar Disc Herniation in Middle Aged and Elderly. J Healthc Eng. 2022 Jan 15;2022:7107702.
[12]YAN J, LIAO Z, YU Y. Finite element analysis of dynamic changes in spinal mechanics of osteoporotic lumbar fracture. Eur J Med Res. 2022 Aug 6;27(1):142.
[13]ZHANG X, CHEN T, MENG F, et al. A finite element analysis on different bone cement forms and injection volumes injected into lumbar vertebral body in percutaneous kyphoplasty. BMC Musculoskelet Disord. 2022 Jun 28;23(1):621.
[14]Wang Jian, Li Kai, Chen Bo et al. Establishment and analysis of three-dimensional finite element model for thoracolumbar vertebral compression fractures [J]. Orthopedic Journal of China,2016,24(16):1498-1503.
[15]Tang Long, Yang Bo, Zhang Bo et al. Clinical Application of Digital Orthopedics in Minimally Invasive Treatment of Severe OVCF [J]. China Digital Medicine,2015,10(01):61-63.
[16]Mou Gang, Ren Weijian. Application of preoperative 3D reconstruction CT scan in vertebral body shaping surgery [J]. Clinical Journal of Medical Officers,2016,44(10):1003-1005.
[17]Yang Fuguo Clinical study of Mimics 3D visualization technology combined with minimally invasive spinal locator [D]. Guangzhou Medical University,2017.
[18]GUO H, LI J, GAO Y, et al. A Finite Element Study on the Treatment of Thoracolumbar Fracture with a New Spinal Fixation System. Biomed Res Int. 2021 Apr 10;2021:8872514.
[19]YU X, RONG PZ, PANG QJ, et al. The Effect on the Fracture Healing following Femoral Neck Shortening after Osteoporotic Femoral Neck Fracture Treated with Internal Fixation: Finite Element Analysis. Biomed Res Int. 2021 Aug 4;2021:3490881.
[20]El-DESOUKY MA, SALEH AA, AMR SM, et al. Finite element analysis modeling of plates versus intramedullary nails in closed comminuted midshaft tibial fractures. SICOT J. 2022;8:26.
[21]WANG D, LI Y, YIN H, et al. Three-dimensional finite element analysis of optimal distribution model of vertebroplasty. Ann Palliat Med. 2020;9(3):1062-1072.
[22]Kuai Yongli Clinical efficacy and finite element analysis of postoperative PKP combined with lumbar and back muscle exercise [D] Yunnan University of Chinese Medicine,2018.
[23]YAO J, DONG B, SUN J, et al. Accuracy and Reliability of Computer-aided Anatomical Measurements for Vertebral Body and Disc Based on Computed Tomography Scans. Orthop Surg. 2020 Aug;12(4):1182-1189.
[24]Liu Liangfeng, Yan Jingang. Clinical value analysis of multi-slice spiral CT three-dimensional reconstruction applied in the diagnosis of lumbar spine fractures [J] Journal of Medical Imaging,2014,24(03):492-494.
[25]Chen Zhiyong, Wang Wenzhen The clinical application value of CT three-dimensional bone reconstruction in lumbar spine fracture surgery [J]. China & Foreign Medical Treatment,2018,37(24):188-190.
[26]YANG CJ, LIN CL, WANG CK, et al. Generative Adversarial Network (GAN) for Automatic Reconstruction of the 3D Spine Structure by Using Simulated Bi-Planar X-ray Images. Diagnostics (Basel). 2022 Apr 30;12(5):1121.
[27]ZAMBORSKY R, KILIAN M, JACKO P, et al. Perspectives of 3D printing technology in orthopaedic surgery. Bratisl Lek Listy. 2019;120(7):498-504.
[28]PORTNOY Y, KOREN J, KHOURY A, et al. Three-dimensional technologies in presurgical planning of bone surgeries: current evidence and future perspectives. Int J Surg. 2023;109(1):3-10. Published 2023 Jan 1.
[29]FITZPATRICK X, FAYZULLIN A, WANG G, et al. Cells-in-Touch: 3D Printing in Reconstruction and Modelling of Microscopic Biological Geometries for Education and Future Research Applications. Bioengineering (Basel). 2023 Jun 5;10(6):687.
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