Intraoperative complications of vertebral body stenting system

Abstract

Background: Vertebral body stenting systems (VBSs) are superior to balloon kyphoplasty for performing vertebral augmentation and height restoration. However, VBS may likely result in more material-related complications that have been under-reported. Here, an 84-year-old female’s vertebral stents “toppled over” before the filling cement was fully applied, thus necessitating an additional posterior fusion. Case Description: An 84-year-old female presented with low back pain after a fall. Dynamic standing and decubitus X-rays revealed a vertebral compression fracture at T12 resulting in an intravertebral vacuum cleft (i.e., the lowermost level of diffuse idiopathic skeletal hyperostosis). When the VBS was performed, the stents “toppled over” just after removing the balloon catheters; we successfully restored with the cement volume in one stent but not the other, thus warranting an additional posterior fusion to maintain stability. Conclusion: The proper injection of cement into a VBS requires dual correct stent positioning, and careful control of requisite stent expansion. In an 84-year-old female with a T12 vertebral body fracture and a remarkable vacuum cleft, the VBS procedure resulted in an inadvertent injection into one stent thus warranting a secondary posterior fusion.

Advances in materials used for minimally invasive treatment of vertebral compression fractures

“…Although, new implant materials have been able to address certain limitations of PVP and PKP, various clinical adverse events continue to occur. For instance, stent tumbling prevents the contralateral stent from providing adequate support (Kanematsu et al, 2023). In this context, a randomized controlled trial evaluated the impact of two different augmentation procedures, namely, the KIVA system and PKP, on the readmission rate due to serious adverse events.…”