Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up.

Cotten, Anne; Dewatre, F.; Cortet, Bernard; Assaker, R.; D, Leblond; Duquesnoy, B; Chastanet, P; Clarisse, J

doi:10.1148/radiology.200.2.8685351

Cited by 838 publications

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“…This complication may occur by means of the basivertebral vein, defects in the posterior vertebral cortex, needle puncture holes, and an inadequate route of the needle [7,27]. With radiologic study, leakage of PMMA is usually detected on intraoperative fluoroscopic images or postoperative radiographs.…”

Section: Discussionmentioning

confidence: 99%

“…The detection rate is low with fluoroscopy and radiography than that with CT [22]. Despite the high rate of PMMA leakage, extrusions of PMMA cement are usually clinically asymptomatic [7,8,25,27]. However, several reports describe the extravasation of PMMA cement into the spinal canal, where it caused severe neurologic complications including complete paralysis and incomplete paraparesis [13,17,20,23].…”

Section: Discussionmentioning

confidence: 99%

“…Extravasations of PMMA into the epidural space of the spinal canal account for 22-38% of all detected PMMA leakages associated with PVP [7,21,22,27]. Because PMMA leaks out of the vertebral bodies through different routes, various patterns of cement distribution can be observed and result in neurologic complications.…”

Section: Discussionmentioning

confidence: 99%

“…Although PVP is validated as a safe and effective procedure, several complications have been reported. Among them, extravasations of PMMA cement is the most prevalent and occurs in 11-81% of PVP cases described in the literature [1,2,4,5,7,9,13,22,27]. Although extravasations of PMMA cement could be reduced by increase of the cement viscosity [3] and are usually of little clinical consequence [7,8,25,27], it can result in severe neurologic complications that require surgical decompression [7,17,[20][21][22][23][24]26].…”

Section: Introductionmentioning

confidence: 99%

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Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine

Lin

Yang

et al. 2006

Eur Spine J

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Although extravasations of polymethylmetharylate during percutaneous vertebroplasty are usually of little clinical consequence, surgical decompression is occasionally required if resultant neurologic deficits are severe. Surgical removal of epidural polymethylmetharylate is usually necessary to achieve good neurologic recovery. Because mobilizing the squeezed spinal cord in a compromised canal can cause further deterioration, attempts to remove epidural polymethylmetharylate in the thoracic region need special consideration. A 66-year-old man had incomplete paraparesis and radicular pain on the chest wall after percutaneous vertebroplasty for osteoporotic compression fracture of T7. Radiological studies revealed polymethylmetharylate extravasations into the right lateral aspect of spinal canal that caused marked encroachment of the thecal sac and right neuroforamina. Progressive neurologic deficit and poor responses to medical managements were observed; therefore, surgical decompression was performed 4 months later.After laminectomy and removal of facet joints and T7 pedicle on the affected side, extravasated polymethylmetharylate posterior and anterior to the thecal sac was completely removed without retracting the dura mater. Spinal stability was reconstructed by supplemental spinal instrumentation and intertransverse arthrodesis with banked cancellous allografts. Myelopathy and radicular pain gradually resolved after decompression surgery. The patient was free of sensory abnormality and regained satisfactory ambulation two years after surgical decompression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine

Lin

Yang

et al. 2006

Eur Spine J

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“…Most cases are clinically silent if not for post-procedure CT. The prevalence may be as high as 40% 812–14. Chiras et al15 reported paraplegia due to cement-related spinal cord compression to occur in only 0.4% of patients.…”

Section: Moderate Complicationsmentioning

confidence: 99%

Percutaneous vertebroplasty complications

Al-Nakshabandi

2011

Annals of Saudi Medicine

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Percutaneous vertebroplasty, among various other options, has become a mainstay in the management of osteoporotic and malignant vertebral fractures. The purpose of this article is to describe complications arising from the procedure, which can be classified as mild, which may include a temporary increase in pain and transient hypotension; moderate, including infection and extravasation of cement into the foraminal, epidural or dural space; and severe such as cement leakage in the paravertebral veins, leading to pulmonary embolism, cardiac perforation, cerebral embolism or even death. Vertebroplasty is not a procedure without complications. The article defines them and describes methods to minimize them.

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Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures

Mathis

Petri

Naff

1998

Arthritis & Rheumatism

166

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This report describes the case of a woman in whom multiple compression fractures of the lower thoracic and lumbar spine occurred in association with long-term corticosteroid therapy for systemic lupus erythematosus. Pain markedly limited the patient's mobility and daily activities, and conservative therapy with bracing and narcotic analgesics gave little improvement. Affected vertebrae were treated with polymethylmethacrylate, introduced percutaneously under fluoroscopic guidance. The resulting reinforcement of the fractured vertebral bodies eliminated the pain and the need for narcotic analgesics. The utilization of percutaneous verterbroplasty as a therapeutic alternative for the treatment of pain resulting from osteoporotic compression fractures is described.

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Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up.

Abstract: Pain relief can occur despite insufficient lesion filling. In most patients, intradiskal and paravertebral leaks of cement had no clinical importance.

Cited by 838 publications

References 0 publications

Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine

Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine

Percutaneous vertebroplasty complications

Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures

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