Abstract:
STUDY DESIGN:A case report and review of the literature are presented. OBJECTIVE:To describe an extremely rare case of combined extraforaminal and intradiscal cement leakage in different vertebral levels following percutaneous vertebroplasty. SUMMARY OF BACKGROUND DATA:Cement leaks in vertebroplasty are relatively common but generally not clinically significant. To our knowledge, this is the first report of extraforaminal cement leakage inducing radiculopathy combined with intradiscal cement leakage evoking acute adjacent compression fracture. METHODS:A 78-year-old woman with L2 and L5 osteoporotic compression fractures received vertebroplasty. Two weeks after surgery, the patient presented severe low back pain radiating to the right thigh, with associated weakness and numbness in the right thigh and lower leg. Roentgenographic images revealed cement leakage into the right extraforamen of L2-L3 as well as leakage into L4-L5 disc with acute adjacent compression fracture of L4. RESULTS:Surgical intervention was required to relieve discomfort. One-stage posterior approach was performed: right L2-L3 intertransverse process approach with removal of extraforaminal leaked cement and posterior instrumentation from L3-L5 and posterior fusion. The severe low back pain, leg pain, and neurologic deficit associated weakness all improved after surgery. CONCLUSION:Although considered a minimally invasive procedure, percutaneous vertebroplasty with polymethylmethacrylate is not risk free. Intractable neurologic complications can occur if it is not performed by experienced physicians under appropriate indications and cautionary safeguards.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Chen JK,Lee HM,Shih JT,Hung STdoi
10.1097/BRS.0b013e31805c0b25subject
Has Abstractpub_date
2007-05-20 00:00:00pages
E358-62issue
12eissn
0362-2436issn
1528-1159pii
00007632-200705200-00020journal_volume
32pub_type
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