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Case Reports
. 2023 Jan 9:9:1087591.
doi: 10.3389/fsurg.2022.1087591. eCollection 2022.

Continuous cement leakage along the posterior longitudinal ligament of the intraspinal epidural during a percutaneous vesselplasty: A case report and literature review

Ning An  1 , Sijia Guo  1 , Jisheng Lin  1 , Haoxiang Zhuang  1 , Hai Meng  1 , Nan Su  1 , Qi Fei  1
Affiliations
Case Reports

Continuous cement leakage along the posterior longitudinal ligament of the intraspinal epidural during a percutaneous vesselplasty: A case report and literature review

Ning An et al. Front Surg. .

Abstract

Objective: This study aims to report one case of intraspinal epidural cement leakage caused by a novel percutaneous vesselplasty.

Methods: A clinical case report from the Orthopedic center of our hospital and a literature review. A 63-year-old woman with an L2 osteoporotic compression fracture underwent novel kyphoplasty, percutaneous vesselplasty. This rare complication was evaluated through a literature search, and its special types are classified in more detail.

Results: The patient was hospitalized with low back pain two weeks after a fall. After auxiliary examination, a new type of percutaneous vesselplasty was performed. After the intraoperative injection of bone cement, bone cement leakage extended along the posterior longitudinal ligament and epidural space. There were no special compression symptoms of the spinal cord, and the prognosis of conservative treatment was good.

Conclusion: Although percutaneous vesselplasty is relatively safe and frequent, intraspinal leakage may occur, so sufficient preoperative evaluation, intraoperative continuous fluoroscopic monitoring, and timely evaluation of postoperative images are extremely necessary.

Keywords: cement leakage; classification standard; complication; epidural; percutaneous kyphoplasty (PKP).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PET-CT images of the patient's preoperative coronal and sagittal vertebral fractures (A–C).
Figure 2
Figure 2
Intraoperative continuous fluoroscopy before the bone cement leakage (A–C front and Side view, D puncture needle entering the vertebral body through the pedicle).
Figure 3
Figure 3
Intraoperative fluoroscopy after bone cement leakage (A,B front and Side view).
Figure 4
Figure 4
Postoperative CT scan 3D reconstruction showed bone cement infiltrating the epidural space of the spinal canal and distributed along the posterior longitudinal ligament from T12 to L2 (A–D) and the filling of bone cement in the posterior spinal canal of the L2 vertebral body(E–K).
See this image and copyright information in PMC

References

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