Biportal Endoscopic Paraspinal Decompression for Epidural Cement Leakage Removal: A Technical Note.

Area of Science:

• Minimally Invasive Spine Surgery
• Endoscopic Spine Procedures
• Neurosurgery

Background:

• Epidural cement leakage is a potential complication following percutaneous vertebroplasty for osteoporotic fractures.
• Neurologic impairment can result from cement extrusion into the spinal canal.
• Traditional surgical approaches for cement removal may involve significant disruption of spinal structures.

Observation:

• A 67-year-old female patient presented with neurologic deficits due to epidural cement leakage post-vertebroplasty.
• Unilateral biportal endoscopy was utilized for cement removal and nerve root decompression.
• The surgical procedure involved accessing the epidural space via a paraspinal approach.

Findings:

• Successful removal of leaked epidural cement was achieved.
• Endoscopic spinal decompression of the L1 and L2 nerve roots was accomplished.
• The patient experienced an uneventful postoperative recovery.

Implications:

• Unilateral biportal endoscopy presents a minimally invasive option for managing epidural cement leaks.
• This technique avoids extensive facet bone removal and instrumented fusion.
• It may be a valuable addition to the surgical armamentarium for spine surgeons.