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[Complications of vertebroplasty]
M A Rauschmann1, D von Stechow, K-D Thomann
1Orthopädische Universitätsklinik, Stiftung Friedrichsheim, Frankfurt/M. M.Rauschmann@friedrichsheim.de
Insights
Percutaneous vertebroplasty, a spinal procedure, has seen increased use and complications. This review details these complications, prevention strategies, and management for better patient outcomes.
Area of Science:
- Interventional Radiology
- Neurosurgery
- Orthopedic Surgery
Background:
- Percutaneous vertebroplasty (PV) was initially developed for spinal hemangiomas.
- Indications have expanded to include osteoporotic compression fractures, osteolytic metastases, and myeloma lesions.
- Increasing PV procedures correlate with a rise in reported complications.
Purpose of the Study:
- To review reported complications associated with percutaneous vertebroplasty.
- To discuss the genesis and management of these complications.
- To present strategies for complication prevention and current therapeutic concepts.
Main Methods:
- Literature review of percutaneous vertebroplasty complications.
- Analysis of case reports detailing complications, their origins, and treatments.
- Presentation of illustrative cases involving cement leakage.
Main Results:
- Complications range from asymptomatic cement leakage to severe outcomes like embolism and neurological deficits.
- A growing body of literature addresses the varied complications of PV.
- Effective management and prevention strategies are crucial due to the procedure's increasing frequency.
Conclusions:
- Percutaneous vertebroplasty, while beneficial, carries risks that necessitate careful management.
- Understanding complication mechanisms is key to developing effective prevention and treatment protocols.
- Ongoing vigilance and adherence to best practices are essential for patient safety in PV procedures.
Abstract:
Percutaneous vertebroplasty was first introduced in 1984 by Galibert et al. for the treatment of hemangiomas in the spine. The current indications for vertebroplasty also include compression fractures due to osteoporosis as well as osteolytic metastases and spinal myeloma lesions. With the numbers of percutaneous vertebroplasty performed by orthopedic and trauma surgeons, neurosurgeons, and radiologists steadily increasing, complications have also risen. Over the last 3 years an increasing number of cases with varying complications, their genesis, and their management have been reported in the literature. Complications include asymptomatic cement leakage, cardiovascular effects, embolism with lethal outcome as well as severe neurological deficits. This article presents a review of the complications reported in the literature, strategies for preventing possible complications as well as current concepts in therapy management. Several of our cases with cement leakages are presented.