PMC10365104_01
Example axial (A) and sagittal (B) CT images demonstrating normal vertebral bodies and the expected location of the basivertebral nerve (yellow star). Example cone-beam CT images acquired using a Medtronic Kyphon  training model showing transpedicular curved canula placement on axial (C), lateral (D), and oblique lateral (E) views. Canula tip placement (red circles) is ideally centrally located within the vertebral body on AP imaging and between 30% and 50% of the anterior-to-posterior length of the vertebral body from the posterior wall on lateral view. Example showing curved canula placement in a patient undergoing kyphoplasty with BVN block (F).
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F1
The positioning of the cannula was determined to be adequate once the distal tip was centrally located within the vertebral body on AP imaging and between 30% and 50% of the anterior-to-posterior length of the vertebral body from the posterior wall on lateral view (Figure 1).
Example intraprocedural fluoroscopic images from two patients (A,B) enrolled in the study are shown. Anteroposterior (A1,B1) and lateral (A2,B2) views demonstrate curved canula positioning in the expected anatomic location of the basivertebral nerve plexus.
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F2
Once positioning was confirmed fluoroscopically (Figure 2), the inner trocar was removed and an intraosseous injection of 5 ml of 2% lidocaine solution was administered via stylet.