2010•Neurosurgery QuarterlyRequires access

Complications of Percutaneous Vertebroplasty

Iraj Lotfinia, Sima Sayyahmelli

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Abstract

Aim Percutaneous vertebroplasty is a safe and effective treatment for patients with severe back pain induced by osteoporotic or neoplastic compression fractures. Although this is a minimally invasive procedure, complications have been reported. Migration of polymethylmethacrylate is the most important complication. Methods and Materials During a 5-year period, 28 patients (13 men and 15 women mean age 61.7 y) underwent fluoroscopy-guided percutaneous vertebroplasty procedures to treat 30 vertebrae. Vertebroplasty was carried out in 73.7% vertebrae with osteoporotic compression fractures. Results Half of patients had no leakage, 23.3% of patients had disk space leakage, 20% of patients epidural and foraminal leakage, and 6.7% of patients had venous epidural leaks. There were no deaths or delayed complications. Mean Visual Analogue Scale before treatment was 76.5±8.72 and after treatment was 21.3±1.07, that means vertebroplasty significantly relief the pain. Four patients had radicular pain that completely resolved with rest and conservative treatment. Conclusions Percutaneous vertebroplasty may have major complications, such as a cement leakage into the epidural spaces, even when carried out by experienced spinal surgeons. Despite the cement leakage percutaneous vertebroplasty-induced complications were rare.

About this research paper

What this paper is about

Aim Percutaneous vertebroplasty is a safe and effective treatment for patients with severe back pain induced by osteoporotic or neoplastic compression fractures. Although this is a minimally invasive procedure, complications have been reported. Migration of polymethylmethacrylate is the most important complication. Methods and Materials During a 5-year period, 28 patients (13 men and 15 women mean age 61.7 y) underwent fluoroscopy-guided percutaneous vertebroplasty procedures to treat 30 vertebrae. Vertebroplasty was carried out in 73.7% vertebrae with osteoporotic compression fractures. Results Half of patients had no leakage, 23.3% of patients had disk space leakage, 20% of patients epidural and foraminal leakage, and 6.7% of patients had venous epidural leaks. There were no deaths or delayed complications. Mean Visual Analogue Scale before treatment was 76.5±8.72 and after treatment was 21.3±1.07, that means vertebroplasty significantly relief the pain. Four patients had radicular pain that completely resolved with rest and conservative treatment. Conclusions Percutaneous vertebroplasty may have major complications, such as a cement leakage into the epidural spaces, even when carried out by experienced spinal surgeons. Despite the cement leakage percutaneous vertebroplasty-induced complications were rare.

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Available abstract

Aim Percutaneous vertebroplasty is a safe and effective treatment for patients with severe back pain induced by osteoporotic or neoplastic compression fractures. Although this is a minimally invasive procedure, complications have been reported. Migration of polymethylmethacrylate is the most important complication. Methods and Materials During a 5-year period, 28 patients (13 men and 15 women mean age 61.7 y) underwent fluoroscopy-guided percutaneous vertebroplasty procedures to treat 30 vertebrae. Vertebroplasty was carried out in 73.7% vertebrae with osteoporotic compression fractures. Results Half of patients had no leakage, 23.3% of patients had disk space leakage, 20% of patients epidural and foraminal leakage, and 6.7% of patients had venous epidural leaks. There were no deaths or delayed complications. Mean Visual Analogue Scale before treatment was 76.5±8.72 and after treatment was 21.3±1.07, that means vertebroplasty significantly relief the pain. Four patients had radicular pain that completely resolved with rest and conservative treatment. Conclusions Percutaneous vertebroplasty may have major complications, such as a cement leakage into the epidural spaces, even when carried out by experienced spinal surgeons. Despite the cement leakage percutaneous vertebroplasty-induced complications were rare.

Key concepts: Medicine, Percutaneous vertebroplasty, Surgery, Fluoroscopy, Percutaneous, Complication, Epidural space, Radiology

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