Brief report
C-arm Cone-beam CT: Applications for Spinal Cement Augmentation Demonstrated by Three Cases

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Spinal canal narrowing as a result of retropulsion of spinal structures before or during cement augmentation has been considered a contraindication to therapy. The authors describe three cases of compression fractures safely treated with cement augmentation with the novel application of C-arm cone-beam computed tomography (CT). All cases involved small amounts of posterior cement extrusion, after which osteotomy needles were left in place during C-arm cone-beam CT. Rapidly reformatted images were viewed with the use of bone windows, yielding three-dimensional visualization of pertinent anatomy to confirm endpoints of posterior extrusion and adequate bone filling.

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Case Reports

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Discussion

Multiple case series describe the efficacy of vertebroplasty for pain control in patients with metastatic spinal disease (10, 11, 12, 13). Significant pain relief is noted immediately in 80%–97% of patients treated. This pain relief appears durable, lasting for months during follow-up. Quality of life and patient mobility significantly improve in a majority of patients with pathologic fractures treated with vertebroplasty (14, 15).

Spinal canal narrowing secondary to a retropulsed fragment has

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