Complications in Percutaneous Vertebroplasty Associated with Puncture or Cement Leakage

Baumann, Clemens; Fuchs, Heiko; Kiwit, J. C. W.; Westphalen, Kerstin; Hierholzer, J.

doi:10.1007/s00270-006-0133-5

Cited by 53 publications

(48 citation statements)

References 7 publications

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“…Although percutaneous vertebroplasty is considered a minimally invasive procedure, several dreadful complications are reported [1,7,25,27,33,34]. We retrospectively reviewed the medical records of patients who underwent vertebroplasty in our institutions and provided the different surgical methods used for patients who required revision surgery to deal with various complications after vertebroplasty failure.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, MRI should be performed for each patient to determine if repeated injection of bone cement will be effective. The reported incidence of cement extrusion is common, including leakage into the vertebral venous system, adjacent discs, lateral or anterior vertebrae, and leakage leading to pulmonary embolism [1,7,23,36]. Most authors have described that cement extrusion presented as asymptomatic in the majority of cases and could be treated conservatively.…”

Section: Discussionmentioning

confidence: 99%

“…Delayed sequelae are also reported, such as adjacent vertebral fracture, cement dislodgement or fragmentation, and pyogenic spondylitis [1,7,25,27,33,34]. Most of these complications can be resolved by conservative treatment, but in some circumstances, surgical intervention is indicated.…”

Section: Introductionmentioning

confidence: 99%

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Revision strategies for complications and failure of vertebroplasties

Yang

Chen

et al. 2008

Eur Spine J

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Percutaneous vertebroplasty is widely discussed in the management of osteoporotic spinal compression fracture, but few reports are available concerning salvage procedures after failure of this technique. We studied 22 percutaneous vertebroplasty patients who required revision surgery upon presentation of new symptoms postoperatively. The indications for revision surgery included recurrent intractable back pain with no response to medical treatment, infectious spondylitis, cement leakage with neurologic deficit, and cement dislodgement and/ or fragmentation. Five patients underwent repeated percutaneous vertebroplasty of the initially cemented vertebrae. Seventeen patients underwent anterior, posterior, or combined anterior and posterior surgery. Four patients required a third surgical procedure because of poor augmentation with cement, subsidence of the anterior bone graft, or pullout of the instrumentation. Finally, four (18%) patients underwent repeat vertebroplasty, two (9%) patients underwent anterior surgery only, one (5%) patient underwent posterior surgery only, and 15 (68%) patients underwent combined anterior and posterior surgery; all but one regained ambulatory status equivalent to that prior to surgery. In conclusion, percutaneous vertebroplasty is a simple and effective, but not risk-or complication-free procedure for the treatment of osteoporotic spinal compression fracture. The spine surgeon should be familiar with varied approaches and techniques for revision surgery. Combined anterior and posterior surgery seems to be the most secure salvage method to treat severely osteoporotic patients in whom percutaneous vertebroplasty initially failed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Revision strategies for complications and failure of vertebroplasties

Yang

Chen

et al. 2008

Eur Spine J

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“…Percutaneous vertebroplasty was first described by Galibert et al in 1987 and has been performed to treated painful vertebral compression fracture secondary to osteoporosis and neoplasms [4]. Is reported that the complications rate associated with PVP is 1-3% [28], including pulmonary cement embolism, cement extravasation with subsequent cord or roots compression associated to neurologic disorders, and allergic reactions [42]. In addition some authors have indicated that there could be an increased risk of collapse in vertebral bodies contiguous to the level treated with PVP [7,28,43].…”

Section: Sandwich Vertebra and Prophylactic Pvpmentioning

confidence: 99%

Is 3T-MR Spectroscopy a Predictable Selection Tool in Prophylactic Vertebroplasty?

Masala

Massari

Assako

et al. 2010

Cardiovasc Intervent Radiol

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This study was designed to confirm relationships between decrease of bone mineral density and increase of marrow fat and to delineate, through MR spectroscopy, vertebral body at high risk for compression fracture onset to justify prophylactic vertebroplasty. We enrolled 127 women: 48 osteoporotic, 36 osteopenic, and 43 normal subjects, who underwent DXA and MR examination of spine. Then, we selected 48 patients with at least two acute osteoporotic vertebral fractures with interposed normal ''sandwich'' vertebrae; all patients underwent MR examination of spine. Significant statistical differences were found among ''Fat Fraction'' (FF) values in normal, osteopenic, and osteoporotic subjects: 59.8 ± 5.1%; 64.8 ± 4.4%; and 67.1 ± 3.3%. A mild, significant, negative correlation was observed between T-score and vertebral fat content (r = -0.585; P = 0.0000). In the second part of the study, 9 new vertebral fractures were observed in 48 patients (19%): 6 were ''sandwich'' vertebrae (12.5%), and 3 were located in distant vertebral body. The mean FF in sandwich fractured vertebrae was 72.75 ± 1.95 compared with the FF of the nonfractured sandwich, and distant control vertebrae were 61.83 ± 3.42 and 61.42 ± 3.64. We found a significant statistical difference between fractured and nonfractured vertebrae (P \ 0.001). The results of this study suggest that MR spectroscopy could be a reliable index to predict the risk of new compression vertebral fracture and could be used for vertebroplasty planning contributing to clarify the possibility to add prophylactic PVP to standard treatment.

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“…ercutaneous vertebroplasty is a relatively noninvasive, low-risk procedure 1,2 that provides immediate and durable pain relief [3][4][5] and improved function 6,7 to patients with painful vertebral compression fractures (VCF).…”

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confidence: 99%

Vertebroplasty: What Is Important and What Is Not

Al-Ali¹,

Barrow²,

Luke³

2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:It is important to try to clarify the methodology of vertebroplasty such as amount of cement needed, how many needles to use and the significance of cement extravasation. This prospective study evaluated the potential of vertebroplasty to increase the likelihood of an adjacent vertebral compression fracture (VCF) 1 year or less after vertebroplasty, the correlation between the cement volumes injected and pain relief, and the consequences of cement extravasation.

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Complications in Percutaneous Vertebroplasty Associated with Puncture or Cement Leakage

Cited by 53 publications

References 7 publications

Revision strategies for complications and failure of vertebroplasties

Revision strategies for complications and failure of vertebroplasties

Is 3T-MR Spectroscopy a Predictable Selection Tool in Prophylactic Vertebroplasty?

Vertebroplasty: What Is Important and What Is Not

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