Cause Analysis of Open Surgery Used After Percutaneous Vertebroplasty and Kyphoplasty

Abstract

BackgroundThe aim of this study was to analyze reasons why open surgery was done after percutaneous vertebroplasty and kyphoplasty.Material/MethodsPatients (587 vertebral bodies) treated with percutaneous vertebroplasty or kyphoplasty in the Xi’an Honghui Hospital of Shanxi Province from January 2008 to January 2012 were retrospectively analyzed and 13 patients were enrolled in the study. These 13 patients had serious adverse events after percutaneous vertebroplasty or kyphoplasty. Their average age was 64.5 years old. Nine patients had spinal cord injury and 4 had nerve root injury. All the patients underwent open surgery within 4–12 h after definitive diagnosis.ResultsAll 13 cases were followed up (average time 14.1 months, range 3–47 months). Reasons for open surgery included cement extravasation (6 cases, 46.2%), puncture mistake (3 cases, 23.1%), and false selection of indications (4 cases, 30.8%). At last follow-up, skin feeling was better than that before open surgery in 4 cases with nerve root injury, and muscle strength recovered to grade 5 (3 cases) and grade 4 (1 case). In 9 cases with spinal cord injury, 7 patients improved and 2 remained at the same ASIA level.ConclusionsThe main reasons for open surgery after percutaneous vertebroplasty and kyphoplasty were cement extravasation (the most common reason), puncture mistake, and false selection of indications.

Radiation Therapy for Solitary Plasmacytoma and Multiple Myeloma: Guidelines From the International Lymphoma Radiation Oncology Group

“…Vertebroplasty is a commonly performed procedure in cases of structural instability due to MM (29, 30) but has not yet been reported to be useful as a primary treatment for SBP. This procedure if used alone is likely to be of limited value initially for vertebral disease with epidural extension and/or spinal cord compression as there is a small risk of further displacing the tumor into the spinal canal, causing neurologic deterioration (31,32). When patients are properly selected, the risks of tumor extravasation into the spinal canal or cement leakage into the epidural space following vertebroplasty are rare complications, limited to case reports (30)(31)(32)(33).…”

Safe radiological spinal intervention: A multicenter snapshot survey of musculoskeletal radiologists in the UK and India

“…This is important to address as the literature reports patients may require decompressive surgery if there is nerve root or spinal cord compression due to cement extravasation after these procedures. [6,[17][18][19] Most, but not all, eligible musculoskeletal radiologists in the present survey have attended at least a BLS course. In the UK, the Resuscitation Council and the General Medical Council stipulate that being able to provide basic first aid and cardiopulmonary resuscitation is an essential competency for all clinicians and BLS training is increasingly being provided earlier in the medical undergraduate curriculum, with refresher courses recommended annually for qualified health-care professionals.…”

Precise Puncture Combined With Simplified Percutaneous Vertebroplasty to Treat Osteoporotic Vertebral Compression Fractures: A Comparative Analysis With Conventional Percutaneous Vertebroplasty

“…After this minimally invasive procedure, the symptoms of local pain were signi cantly improved, and the patients can get out of bed 2 days following surgery, realizing minimally invasive and rapid recovery effect [4][5][6]. Although PVP technique has been reported to be safe in all countries, with the widespread applied at different levels of hospitals and continues increasing of surgical cases, complications of intraoperative puncture and bone cement leakage have been more and more reported [2][3][4][8][9][10]. Saracen et al [9].retrospectively analyzed the clinical information of 616 patients (1100-segment vertebra) who received PVP treatment, and found that the incidence of perioperative complications was as high as 41.7%.…”

“…Hsieh et al [10] reported that the spinal leakage rate was 0.17%, and 4 patients need extra surgical decompression. In the study of Xu et al [8] Currently, the safety of PVP procedure is improved mainly by two ways. Firstly, accuracy of puncture and channel establishment is increased, avoiding injury to important blood vessels and nerves around vertebrae, as well as the damaged region of vertebral cortex or endplate [11].…”