This paper presents the case report of an 88 year old female who came to hospital suffering from a severe lower back pain. Ten days before, she had undergone a vertebroplasty with injection of cement into lumbar vertebra 3 because of an osteoporotic fracture. This treatment did not result in a reduction of the lower back pain, which was the main reason for the procedure. However, the patient claimed to have increasing pain radiating to her left leg. Furthermore, she suffered from numbness of her left leg. Clinical examination showed a lack of power in this leg according to hip flexion with a degree of 3/5. X-ray examinations showed paravertebral cement particles and led to the suspicion that the paravertebral cement had caused nerve root compression. MRI and CT myelography showed that the cement had drained into the intraspinal, extradural venous plexus (Batson's plexus). The plexus was filled out with cement between L2 and L5 on both sides. There was nearly no cement in the fractured vertebra L3, but cement had also run onto the paravertebral veins up to the vena cava, which was also involved. The cemented veins had led to a stenosis of the neuroforamina L2 and L3 on the left side. The result was compression of left L3 nerve root. After consulting with our vascular surgeons, we decided on a non-operative treatment. We prescribed a lumbar brace as external stabilisation and as an antithrombotic treatment we gave the patient weight adapted low molecular weight heparin.
p = 0,03, Fisher's exact test, odds ratio: 6,2 (95 % KI: 1,4±27,1); a keine hCG-Gabe bei > 12 Follikeln ³ 15 mm und/oder Östradiol ³ 4.000 pg/ml; Angaben sind Mittelwerte Standardabweichung, wenn nicht anders angegeben Abb. 1~Verlauf der Follikelreifung in Abhängigkeit von der Follikelgröûe im langen Agonisten-und Cetrorelix-Mehrfachgabe-Protokoll. (Abbildung aus Ludwig et al. 2000 b)
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