Pyogenic Spondylitis after Vertebroplasty - A Report of Two Cases -

Lee, Chang Bum; Kim, Hyung Sup; Kim, Yong Jin

doi:10.4184/asj.2007.1.2.106

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…To reduce the risk of such complications, it has been recommended that PVP or BKP should not proceed until the patient has made a complete recovery from any existing infections, and that, in cases of recent infection, either antibiotics should be prescribed on a long-term basis to avoid deep infection or a cement-antibiotic mixture should be used. 293 Intraoperative balloon perforation during kyphoplasty seems unlikely to lead to any serious complications. Nevertheless, Saliou et al 219 have suggested a number of methods to minimise the incidence of rupture: (1) purge any trapped air from the balloon to prevent gas embolism, (2) increase balloon inflation pressure very slowly, to allow the balloon to adapt to the solid, sharp, bony environment, and (3) use a curette to break bone bridges and constitutive bone fragments before inflating the balloon.…”

Section: Summary and Discussion Of Data Relating To Adverse Eventsmentioning

confidence: 99%

“…A number of case reports [291][292][293][294][295][296][297][298][299][300][301][302] have described postoperative infectious complications. While such infections can occasionally be managed with a medical approach, they often necessitate further surgical intervention.…”

Section: Postoperative Infectionmentioning

confidence: 99%

“…While such infections can occasionally be managed with a medical approach, they often necessitate further surgical intervention. 293,294,[296][297][298]300,302 One team 292 reported the death of a patient from septic multiple organ failure after antibiotic treatment and local surgical interventions.…”

Section: Postoperative Infectionmentioning

confidence: 99%

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Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis

Stevenson

Gomersall

Jones

et al. 2014

Health Technology Assessment

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Section: Summary and Discussion Of Data Relating To Adverse Eventsmentioning

confidence: 99%

Section: Postoperative Infectionmentioning

confidence: 99%

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Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis

Stevenson

Gomersall

Jones

et al. 2014

Health Technology Assessment

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“…The patient cohort investigated by us is in general following the pattern of the technical incidents and complications reported in the literature (2,4,6,13,16,17,(19)(20)(21)(22)(23)(24)(25). Apart from some rare complications like infections, fatty emboli, incidental durotomies, rib fractures, etc., we have seen the majority of the complications reported by the other authors.…”

Section: Discussionmentioning

confidence: 99%

Surgical complications and unwated events in the modern percutaneous vertebroplasty treatment

Kalevski

Haritonov

Peev

et al. 2016

SSM

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AIM: The modern spinal surgery accepts the percutaneous vertebroplasty (PV) with polymethylmethacrylate (PMMA) as a routine procedure for treatment of painful osteoporotic, neoplastic and traumatic compression fractures in the thoracic and lumbar region of the spinal column. Although considered to be a minimally invasive and safe procedure, it could be affected by severe disabling and even life-threatening complications. The aim of the present study is to evaluate the different potential complications with their clinical presentation, diagnostics and different treatment options. MATERIALS AND METHODS: The study analyzed a cohort of 56 consecutive patients (66 levels) treated with PV in our clinic for the period January, 2008-July, 2012. Of them, 31 (55.4%) were women and 25 (44.6%)-men at a mean age of 61.7 (23-80) years. The osteoporotic and traumatic compression fractures subgroup was comprised of 44 (78.6%) patients, while the patients with neoplastic fractures were 12 (21.4%). All the fractures were classified as A1 Magerl's fractures with no neurologic deficit. RESULTS: Complications and unwanted events were registered in 9 (16.1%) patients. Of them, 2 experienced transient increased pain syndrome intensity, one of the patients presented with index level radiculopathy, 2 patients were diagnosed with extravertebral leakage of the cement in the spinal canal with compression of the neural structures and subsequently operated, 1 patient had a cement leak in the adjacent disk, 2 patients-a cement leak in the paravertebral soft tissues and the paravertebral venous system, and one had cement pulmonary embolism. CONCLUSION: PV is a minimally invasive and effective procedure that is used in the treatment of painful osteoporotic, traumatic and neoplastic compression fractures on neurologically intact patients. The clinically significant complications and unwanted events are a relatively rare encounter and in the majority of the cases are treatable with conservative measures. The epidural cement migration with neural elements compression is the only indication for surgical decompression and removal of the compressing cement.

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Simultaneous-onset infectious spondylitis with vertebral fracture mimicking an acute osteoporotic vertebral fracture erroneously treated with balloon kyphoplasty: illustrative case

Yonezawa

Tokuumi

Komine

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Early balloon kyphoplasty (BKP) intervention for acute osteoporotic vertebral fracture (OVF) has been reported to be more effective than the conservative treatment. However, complications of early BKP intervention are still unknown. OBSERVATIONS A 71-year-old patient with OVF of L2 underwent BKP 2 weeks after symptom onset. Preoperative magnetic resonance imaging (MRI) and radiograph were compatible with new L2 OVF. Although computed tomography (CT) images revealed the atypical destruction of lower endplate of L2 as OVF, L2 BKP was planned. After BKP, his back pain improved dramatically. Two weeks after BKP, his lower back pain recurred. MRI and CT confirmed the diagnosis of infectious spondylitis with paravertebral abscess formation. With adequate antibiotic treatment and rehabilitation, he was symptom-free and completely ambulatory without signs of infection. LESSONS Signal changes on the fractured vertebral bodies during initial MRI and fractured vertebral instability on radiograph can mislead the surgeon to interpret the infection as a benign compression fracture. If the patients exhibit unusual destruction of the endplate on CT imaging, “simultaneous-onset” spondylitis with vertebral fracture should be included in the differential diagnosis. To determine the strategy for OVF, preoperative biopsy is recommended if simultaneous-onset spondylitis with vertebral fracture is suspected.

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Pyogenic Spondylitis after Vertebroplasty - A Report of Two Cases -

Cited by 6 publications

References 7 publications

Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis

Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis

Surgical complications and unwated events in the modern percutaneous vertebroplasty treatment

Simultaneous-onset infectious spondylitis with vertebral fracture mimicking an acute osteoporotic vertebral fracture erroneously treated with balloon kyphoplasty: illustrative case

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