Abstract No. 386: Percutaneous vertebroplasty performed with an 18 G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy

Abstract

No. 386 Percutaneous vertebroplasty performed with an 18 G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy L. Chen, R. Ni; Interventional Radiology, The First Affiliated Hospital of Suzhou University, SuZhou, China Purpose: Percutaneous vertebroplasty (PVP) provides pain relief and strengthening of the bone of vertebrae weakened by disease. It is increasingly accepted as one of the treatment options in the management of intractable pain due to vertebral compression. Severe vertebral compression, refers to vertebral body collapse to less than one-third of its original height and is considered to be a situation in which PVP is technically difficult to perform, especially for the treatment of cervical vertebral body. The purpose of this study was to investigate the clinical feasibility and efficacy of PVP performed with an 18G needle for the treatment of severe compression fractures of cervical vertebral body due to malignancy. Materials and Methods: PVP was performed in 4 patients with severe compression fractures of cervical vertebral body due to malignanc. A total of 5 diseased vertebral bodies were detected, which distributed in the C5 (n 1), C6 (n 3), C7 (n 1) vertebral bodies. Under fluoroscopic guidance an 18G needle was punctured into the target vertebral body and then polymethylmethacrylate bone cement was in. A follow-up lasting for one month was conducted. Results: The technical success of both needle puncturing and bone cement injection was achieved in all patients. The mean amount of bone cement injected in each diseased vertebra was 2.2 ml (1.5 3.2)m1. Marked pain relief was quickly obtained in all 4 patients. No major complications occurred in this series, except for asymptomatic bone cement leaking around vertebra which appeared in one vertebral bodies. Conclusion: PVP with 18G needle is a safe, effective technique in treating the malignant severe cervical vertebral body compression fractures. Educational Exhibit Abstract No. 387 Simulation training in percutaneous image-guided interventions J. Ghassemi, B. Jeun, B.B. Pua; Radiology, Weill Cornell Medical Center, New York, NY Learning Objectives: Users will gain familiarity with key technical aspects and necessary steps required for percutaneous imageguided interventions, namely the placement of an abscess drainage catheter. Background: Current limitations in resident work hours, though essential for physician health and decision-making, has unfortunately resulted in decreased hands on procedural and operative experience. This paradigm shift has resulted in the need for accurate simulation modules to allow the training physician to both learn the steps of procedures as well as develop comfort in its technical aspects. We have developed a software application that simulates the sequential steps required for percutaneous image-guided interventions. The program was written in the Adobe Flash environment to construct an interactive graphical display interface (GUI) to enhance the user experience. Clinical Findings/Procedure Details: Our training module simulates the deployment of a CT-guided drainage catheter. Briefly, a video of an actual abscess drainage case was recorded after obtaining patient consent. The video was subsequently edited and imported into our software program, which also utilizes a list of images that a user can select from the computer screen. Each image, which represents a key step in the procedure, is temporally synchronized to its appropriate position in the video. For instance, an image of a biopsy grid may be associated with video playback demonstrating the technique of localizing proper site of percutaneous access. The list of images is randomized, and the simulation will only proceed forward if the end user selects the correct chronologic sequence of steps. Lastly, a narrative is provided throughout the video to provide more details on each step. Conclusion and/or Teaching Points: Simulation technologies play an integral role in medical training and practice. We have developed a training module that simulates the sequential steps required in the placement of a CT-guided percutaneous drainage catheter. Educational Exhibit Abstract No. 388 Complications of percutaneous radiological gastrostomy/gastrojejunostomy tube insertions: S154 Poster Sessions JVIR Po st er Se ss io ns