The major complications of transpedicular vertebroplasty
- 1 November 2009
- journal article
- case report
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery: Spine
- Vol. 11 (5), 607-613
- https://doi.org/10.3171/2009.4.spine08466
Abstract
Vertebroplasty is a well-known technique used to treat pain associated with vertebral compression fractures. Despite a success rate of up to 90% in different series, the procedure is often associated with major complications such as cord and root compression, epidural and subdural hematomas (SDHs), and pulmonary emboli, as well as other minor complications. In this study, the authors discuss the major complications of transpedicular vertebroplasty and their clinical implications during the postoperative course. Vertebroplasty was performed in 12 vertebrae of 7 patients. Five patients had osteoporotic compression fractures, 1 had tumoral compression fractures, and 1 had a traumatic fracture. Two patients had foraminal leakage, 1 had epidural leakage, 1 had subdural cement leakage, 2 had a spinal SDH, and the last had a split fracture after the procedure. Three patients had paraparesis (2 had SDHs and 1 had epidural cement leakage), 3 had root symptoms, and 1 had lower back pain. Two of the 3 patients with paraparesis recovered after evacuation of the SDH and subdural cement; however, 1 patient with paraparesis did not recover after epidural cement leakage, despite cement evacuation. Two patients with foraminal leakage and 1 with subdural cement leakage had root symptoms and recovered after evacuation and conservative treatment. The patient with the split fracture had no neurological symptoms and recovered with conservative treatment. Transpedicular vertebroplasty may have major complications, such as a spinal SDH and/or cement leakage into the epidural and subdural spaces, even when performed by experienced spinal surgeons. Early diagnosis with CT and intervention may prevent worsening of these complications.This publication has 23 references indexed in Scilit:
- Delayed L2 Vertebrae Split Fracture following KyphoplastyPain Practice, 2009
- An Intraatrial Thrombus and Pulmonary Thromboembolism as a Late Complication of Percutaneous VertebroplastyAnesthesia & Analgesia, 2007
- Infected VertebroplastySpine, 2006
- Infected Vertebroplasty Due to Uncommon Bacteria Solved Surgically: A Rare and Threatening Life Complication of a Common ProcedureSpine, 2006
- CT-gesteuerte Vertebro- und Kyphoplastie: Vergleichende Untersuchung zu technischem Erfolg und Komplikationen bei 101 EingriffenRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2006
- Intradural Cement LeakageSpine, 2006
- Vertebroplasty and Kyphoplasty for Osteolytic Vertebral CollapseClinical Orthopaedics and Related Research, 2003
- Percutaneous vertebroplasty: indications, contraindications, and techniqueThe British Journal of Radiology, 2003
- An In Vivo Comparison of the Potential for Extravertebral Cement Leak After Vertebroplasty and KyphoplastySpine, 2002
- Vertébroplasties percutanéesLa Revue de Médecine Interne, 1995