Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Mar 18:2016:bcr2016214510.
doi: 10.1136/bcr-2016-214510.

Anterior spinal fixation for recollapse of cemented vertebrae after percutaneous vertebroplasty

Narihito Nagoshi  1 , Kentaro Fukuda  2 , Masanobu Shioda  3 , Masafumi Machida  4
Affiliations
Case Reports

Anterior spinal fixation for recollapse of cemented vertebrae after percutaneous vertebroplasty

Narihito Nagoshi et al. BMJ Case Rep. .

Abstract

Although recollapse after percutaneous vertebroplasty (PV) is a serious complication that needs salvage surgery, there is no consensus regarding the best operative treatment for this failure. We present cases of 3 patients, diagnosed as having thoracic osteoporotic vertebral fractures, who had undergone PV at other institutes. Within less than half a year, recollapse occurred at the cemented vertebrae in all 3 patients, and we conducted anterior spinal fixation (ASF) on them. In all cases, ASF relieved the patient's severe low back pain, and there was no recurrence of symptoms during the follow-up period of 6 years, on average. ASF is the optimal salvage procedure, since it allows for the direct decompression of nerve tissue with reconstruction of the collapsed spinal column, and preservation of the ligaments and muscles that stabilise the posterior spine. Surgeons who perform PV need to be able to assess this failure early and to perform spinal fixation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Case 1: An 87-year-old woman with a postpercutaneous vertebroplasty T12 recollapse. Radiographs showing the cemented vertebra just after the vertebroplasty (A and B) and 4 months later (C and D). Recollapse of the T12 vertebra progressed over time.
Figure 2
Figure 2
Two months after percutaneous vertebroplasty in case 1. (A and B) CT images showing cement fragmentation in the T12 vertebra. (C) T1-weighted and (D) T2-weighted MRI showing vertebral recollapse.
Figure 3
Figure 3
Case 2: a 74-year-old woman with postpercutaneous vertebroplasty T11 and T12 recollapse. (A) Radiographic and (B) CT images showing cemented T11 and T12 vertebrae just after vertebroplasty. Cement leakage into the spinal canal was observed at T12 (B: arrowhead). Seven months after vertebroplasty, (C) radiographic and (D) CT images showing progressive recollapse and cement leakage (arrowhead).
Figure 4
Figure 4
(A) T1-weighted and (B) T2-weighted MRI in case 2 showing fluid collection around the cement at the T12 vertebra.
Figure 5
Figure 5
(A and B) Case 3: A 64-year-old woman with postpercutaneous vertebroplasty L1 recollapse seen on radiographs.
Figure 6
Figure 6
Post-anterior spinal fixation (ASF) images for case 1. (A and B) Radiographic and (C and D) CT images showing successful ASF with an iliac crest autograft. (E and F) One year after ASF, radiographic images showing bony fusion.
Figure 7
Figure 7
Post-anterior spinal fixation (ASF) radiographs for case 2. (A and B) Radiographs obtained 7 years after ASF showing bony fusion at the T10-L1 levels.
Figure 8
Figure 8
(A and B) Case 3: after recollapse of cemented vertebra, the patient underwent anterior spinal fixation with iliac crest autografts at T12-L2. (C and D) Radiographs at 10-year follow-up showing solid bony fusion at T12-L2.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992;13(Suppl 2):S27–31. 10.1016/8756-3282(92)90193-Z - DOI - PubMed
    1. Galibert P, Deramond H, Rosat P et al. . [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. Neurochirurgie 1987;33:166–8. - PubMed
    1. Yimin Y, Zhiwei R, Wei M et al. . Current status of percutaneous vertebroplasty and percutaneous kyphoplasty—a review. Med Sci Monit 2013;19:826–36. 10.12659/MSM.889479 - DOI - PMC - PubMed
    1. Abdul-Jalil Y, Bartels J, Alberti O et al. . Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty. Spine 2007;32:E589–93. 10.1097/BRS.0b013e31814b84ba - DOI - PubMed
    1. Baumann C, Fuchs H, Kiwit J et al. . Complications in percutaneous vertebroplasty associated with puncture or cement leakage. Cardiovasc Intervent Radiol 2007;30:161–8. 10.1007/s00270-006-0133-5 - DOI - PubMed

Publication types