What should be monitored to confirm proper needle placement during kyphoplasty?

To confirm proper needle placement during kyphoplasty, monitoring with both anteroposterior (AP) and lateral fluoroscopy is essential. These imaging techniques provide real-time visualization of the needle's trajectory and position relative to the vertebral body and surrounding structures, allowing the interventional radiologist to ensure that the needle is accurately placed within the intended area of the vertebral body for cement injection.

Using AP and lateral fluoroscopy offers a comprehensive view of the needle's location from multiple angles, which helps to avoid complications such as extravasation of the cement into the surrounding tissues or unintentional placement into non-target areas. This dual-plane imaging technique is crucial for safe and effective procedural outcomes.

While CT scans and magnetic resonance imaging (MRI) can provide detailed cross-sectional and soft tissue images, they are typically not utilized in real-time during the procedural phase of kyphoplasty, as they do not provide the rapid feedback needed for immediate adjustments during needle placement. Standard X-ray imaging alone may not provide the necessary detailed visualization of the needle path as can be obtained with fluoroscopy, especially for evaluating the exact placement in the three-dimensional space of the vertebral body. Hence, the combination of AP and lateral fluoroscopy is the optimal approach in this context