Percutaneous vertebroplasty: state of the art.

Cotten, Anne; Boutry, Nathalie; Cortet, Bernard; Assaker, R.; Demondion, Xavier; D, Leblond; Chastanet, P; Duquesnoy, B; Deramond, H.

doi:10.1148/radiographics.18.2.9536480

Cited by 476 publications

(280 citation statements)

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“…The principal complication in PVP is epidural or foraminal leakage of PMMA that damages to the spinal cord and/or nerve roots [5]. 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].…”

Section: Discussionmentioning

confidence: 99%

“…Initial successes were achieved in treating aggressive vertebral hemangiomas [6,10,11], painful osteolytic vertebral metastases, and myelomas [5,15,25]. Indications of PVP with PMMA have been extended to the treatment of vertebral compression fractures secondary to osteoporosis [8,9,12,16,18,19].…”

Section: Introductionmentioning

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: Introductionmentioning

confidence: 99%

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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“…Recent advances in the management of vertebral hemangiomas are the intralesional injection of absolute ethanol [19,29] and percutaneous vertebroplasty [6,21]. Vertebroplasty is an effective new radiologic procedure consisting of the percutaneous injection of a biomaterial, usually methyl methacrylate, into a lesion of a vertebral body.…”

Section: Discussionmentioning

confidence: 99%

Pain pattern in multiple vertebral hemangiomas involving non-adjacent levels: report of two cases

Korres

Karachalios

Roidis

et al. 2000

European Spine Journal

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IntroductionHemangioma is a benign tumor consisting of blood vessels. There are two types: generalized and localized. In the generalized type there is involvement of multiple organs such as the liver, skin and bone [7]. Localized hemangiomas are the most common. In the skeleton, the most common site is the spine, followed by the skull and pelvis. Hemangiomas are often asymptomatic and discovered accidentally, but they may cause back pain or spinal cord compression in some cases. Radiographic and CT evidence of the hemangioma are characteristic. Multiple lesions of the spine are rather uncommon. Management of the patient depends on the severity of the symptoms, and may be either conservative or surgical.We present the cases of two patients with multiple hemangiomas of the spine involving multiple non-adjacent vertebrae and we comment on the possible clinical significance of their presentation. Case reports Case 1A 68-year-old man initially presented at the outpatient clinic because of persistent low back-pain. Radiographs revealed hemangiomas of the L3 and L4 vertebrae (Fig. 1). Conventional radiographs of the upper spine were normal. The patient was treated by conservative means. He was given non-steroidal anti-inflammatory drugs (NSAID) and a course of physiotherapy, and he was soon symptom free. At a follow up examination 1 year later, he was symptom free and was discharged. He was advised to attend annual follow-up examinations but did not.The patient came back to the clinic 15 years later complaining of suffering acute back pain localized in the area of T8-T10 during the previous 3 months. Common pain-killers gave him no relief. On examination, there was no evidence of neurologic involvement,

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“…It is a consequence of inflammatory reaction due to heat generated by polymerization of methyl methacrylate 1. Although it rarely lasts for more than a few hours, it can be easily managed with analgesics (steroidal or nonsteroidal).…”

Section: Mild 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: state of the art.

Cited by 476 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

Pain pattern in multiple vertebral hemangiomas involving non-adjacent levels: report of two cases

Percutaneous vertebroplasty complications

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