A technique to circumvent subcutaneous cement tracts during percutaneous vertebroplasty

Abstract

The deposition of a subcutaneous cement tract is a potential complication of percutaneous vertebroplasty. These tracts can be a source of pain and tenderness for the patient. We describe a case of symptomatic cement deposition within a needle tract in the subcutaneous tissues that required surgical removal, and we describe a technique to prevent this complication in a second patient, by using needle redirection to cut across the cement core.

Fig 1.

Cement is seen in the needle tract of the subcutaneous tissues of the lower thorax, extending dorsally from the T9 vertebral body cement deposition site (arrows).

Fig 2.

Deposition of a subncutaneous cement tract is averted. A, Cement column, visualized in the posterior T11 vertebral body (arrow) as needle withdrawal is first begun. B, The cement column inside the needle is broken at the tip of the needle (arrow) by pulling the needle hub inferiorly and advancing the tip of the needle toward the superior endplate. C, The needle can then be withdrawn without further cement deposition in the needle tract (arrow).