PMC

a C-arm X-ray image. 4-mm biopsy needle positioned into disc L2-3. The radiological image is a print out from the C-arm instrument, perpendicular view. b C-arm image: 18 gauge needles positioned into L1-2 and L2-3 prior to the injection

A: Lateral fluoroscopy showing the initial 11 gauge vertebroplasty cannula (solid black arrow) within the T12-L1 disc space before contrast injection
B: Anterior-posterior view showing curette (cu) advancing into the T12-L1 disc space toward the vertical fracture of T12 through the cannula (solid black arrow). The spinal needles mark the pedicles (wide black arrows).
C: Initial injection of bone cement into the T12-L1 disc space (solid white arrow) through the cannula (black arrow). The cement is starting to move across the disc space toward the base of the fracture (dashed white arrow).
D: Anterior-posterior (AP) view. The cannula (solid black arrow) and cement (solid white arrows) is close to the base of the vertical fracture of T12. The pedicles are marked with spinal needles (wide black arrows).
E: Lateral view showing the second cannula through the pedicle of T12 vertebra (dashed black arrow). Cement has been injected into the vertical part of the fracture and actually flowed inferiorly toward the T12-L1 disc space connecting with the cement in the interspace (solid white arrows).
F: AP view showing cannula through pedicle of T12 (dashed black arrow) with cement flowing into vertical avulsion fracture as well as interspace of T12-L1 (solid white arrows). The original cannula in the T12-L1 disc space can be seen (solid black arrow).

Customization of the bar. A: After combining ball joint and tube bar on one side, the tube bar gauge was connected on the other side, B: Tube bar was cut off at the gap of tube bar gauge with disc.