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Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty: a case report
Tsung-Ting Tsai1, Wen-Jer Chen, Po-Liang Lai
1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Spine
|November 19, 2003
Summary
A rare complication of delayed cement displacement after percutaneous vertebroplasty occurred in a patient with an osteoporotic vertebral fracture. Surgical intervention successfully resolved the issue, improving the patient's symptoms.
Area of Science:
- Spinal surgery
- Interventional radiology
- Orthopedic surgery
Background:
- Percutaneous vertebroplasty is a minimally invasive procedure for osteoporotic compression fractures.
- While generally safe, complications can arise, including rare instances of cement displacement.
- Delayed cement displacement following percutaneous vertebroplasty has not been previously reported.
Observation:
- A 69-year-old male patient underwent percutaneous vertebroplasty for a T12 osteoporotic compression fracture.
- One month post-procedure, the patient experienced severe back pain.
- Radiographic imaging showed anterior cortical breakdown of the T12 vertebra with cement displacement.
Findings:
- The patient underwent a single-stage anterior and posterior surgery.
- The procedure involved a thoracoabdominal approach to remove displaced cement and posterior instrumentation from T11 to L1.
- Post-operative recovery showed improvement in back pain and associated weakness.
Implications:
- Delayed cement displacement is a rare complication of percutaneous vertebroplasty.
- This complication may be more likely in cases of osteoporotic vertebral fractures with avascular necrosis and anterior cortical defects.
- Early recognition and surgical management are crucial for favorable outcomes.