Major Neurological Complications Following Percutaneous Vertebroplasty with Polymethylmethacrylate : A Case Report

Major Neurological Complications Following Percutaneous Vertebroplasty with... <h2>Introduction</h2> The technique of percutaneous vertebroplasty was developed by Galibert et al. 1 to manage refractory vertebral-body compression fractures secondary to osteoporosis. It involves injection of polymethylmethacrylate into the collapsed vertebral body in order to augment the deficient bone and to relieve pain. It also requires placement of a large-bore (10-gauge) spinal needle under fluoroscopic guidance into each affected vertebral body through a posterior bilateral transpedicular approach 2 . Vertebroplasty has been performed for approximately 200 patients with osteoporotic vertebral collapse 2 - 10 , but not a single instance of spinal-cord compromise or major extrusion of polymethylmethacrylate into the spinal canal has been described. I am aware of only one instance in which a peripheral neuropathy was attributed to the leakage of cement into a neural foramen, and this transient complication resolved spontaneously 3 . The current case report documents the catastrophic extrusion of polymethylmethacrylate, both into the spinal canal and into neural foramina at multiple levels of the thoracolumbar spine, following vertebroplasty in an osteoporotic patient. <h2>Case Report</h2> A sixty-six-year-old woman with multilevel vertebral osteopenia and recent spontaneous compression fractures of the tenth and eleventh thoracic and first lumbar vertebral bodies presented to a local neurosurgeon http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Bone and Joint Surgery Wolters Kluwer Health

Major Neurological Complications Following Percutaneous Vertebroplasty with Polymethylmethacrylate : A Case Report

Journal of Bone and Joint Surgery, Volume 83 (7): 1070 – Jul 1, 2001
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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2001 by The Journal of Bone and Joint Surgery, Inc.
ISSN
0021-9355
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Abstract

<h2>Introduction</h2> The technique of percutaneous vertebroplasty was developed by Galibert et al. 1 to manage refractory vertebral-body compression fractures secondary to osteoporosis. It involves injection of polymethylmethacrylate into the collapsed vertebral body in order to augment the deficient bone and to relieve pain. It also requires placement of a large-bore (10-gauge) spinal needle under fluoroscopic guidance into each affected vertebral body through a posterior bilateral transpedicular approach 2 . Vertebroplasty has been performed for approximately 200 patients with osteoporotic vertebral collapse 2 - 10 , but not a single instance of spinal-cord compromise or major extrusion of polymethylmethacrylate into the spinal canal has been described. I am aware of only one instance in which a peripheral neuropathy was attributed to the leakage of cement into a neural foramen, and this transient complication resolved spontaneously 3 . The current case report documents the catastrophic extrusion of polymethylmethacrylate, both into the spinal canal and into neural foramina at multiple levels of the thoracolumbar spine, following vertebroplasty in an osteoporotic patient. <h2>Case Report</h2> A sixty-six-year-old woman with multilevel vertebral osteopenia and recent spontaneous compression fractures of the tenth and eleventh thoracic and first lumbar vertebral bodies presented to a local neurosurgeon

Journal

Journal of Bone and Joint SurgeryWolters Kluwer Health

Published: Jul 1, 2001

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