Effectiveness of percutaneous endoscopic technique in treatment of intraspinal cement leakage after percutaneous vertebroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YU Qingshuai , CHEN Liang , YAN Zhengjian , CHU Lei , SHI Lei ,  DENG Zhongliang

Department of Orthopedics, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, P.R.China;

Corresponding author：

DENG Zhongliang, Email: zhongliang.deng@qq.com

Keywords：

Percutaneous endoscopic technique; percutaneous vertebroplasty; intraspinal cement leakage; spinal cord injury

DOI：

10.7507/1002-1892.201612139

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the feasibility and safety of percutaneous endoscopic technique in the treatment of intraspinal cement leakage after percutaneous vertebroplasty (PVP). Methods Between May 2014 and March 2016, 5 patients with lower limb pain and spinal cord injury caused by intraspinal cement leakage after PVP, were treated with percutaneous endoscopic spinal decompression. Of 5 cases, 3 were male and 2 were female, aged from 65 to 83 years (mean, 74.4 years). The course of disease was 10-30 days (mean, 16.2 days). Imageological examinations confirmed the levels of cement leakage at T ₁₂, L ₁ in 3 cases, and at L _{1, 2} in 2 cases; bilateral sides were involved in 1 case and unilateral side in 4 cases. Two patients had lower limb pain, whose visual analogue scale (VAS) were 8 and 7; 3 patients had lower extremities weakness, whose Japanese Orthopedic Association (JOA) 29 scores were 18, 20, and 19. According to American Spinal Injury Association (ASIA) impairment scale, neural function was rated as grade E in 2 cases and grade D in 3 cases. Results The operation time was 55-119 minutes (mean, 85.6 minutes), and the blood loss was 30-80 mL (mean, 48 mL). CT scan and three-dimensional (3D) reconstruction at 1 day after operation showed that cement leakage was removed in all patients. Five cases were followed up 6-21 months (mean, 12 months). In 2 patients with lower limb pain, and VAS score was significantly decreased to 2 at last follow-up. In 3 patients with lower extremities weakness, the muscle strength was improved progressively, and the JOA29 scores at last follow-up were 21, 23, and 22. Conclusion Percutaneous endoscopic technique for intraspinal cement leakage after PVP is safe, effective, and feasible.

Citation： YU Qingshuai, CHEN Liang, YAN Zhengjian, CHU Lei, SHI Lei, DENG Zhongliang. Effectiveness of percutaneous endoscopic technique in treatment of intraspinal cement leakage after percutaneous vertebroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(6): 690-695. doi: 10.7507/1002-1892.201612139 Copy

1.	Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie, 1987, 33(2): 166-168.
2.	Burton AW, Mendoza T, Gebhardt R, et al. Vertebral compression fracture treatment with vertebroplasty and kyphoplasty: experience in 407 patients with 1,156 fractures in a tertiary cancer center. Pain Med, 2011, 12(12): 1750-1757.
3.	Bonnard E, Foti P, Kastler A, et al. Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience. Eur Radiol, 2017, 27(4): 1512-1516.
4.	La Maida GA, Giarratana LS, Acerbi A, et al. Cement leakage: safety of minimally invasive surgical techniques in the treatment of multiple myeloma vertebral lesions. Eur Spine J, 2012, 21 Suppl 1: S61-S68.
5.	Corcos G, Dbjay J, Mastier C, et al. Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors. Spine (Phlia Pa 1976), 2014, 39(5): E332-E338.
6.	Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factors. Spine J, 2011, 11(9): 839-848.
7.	Tomé-Bermejo F, Piñera AR, Duran-Álvarez C, et al. Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture. Spine, 2013, 9(Supplement): S90.
8.	Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients. Medicine (Baltimore), 2016, 95(24): e3850.
9.	Kulkarni AG, Shah SP, Deopujari CE. Epidural and intradural cement leakage following percutaneous vertebroplasty: a case report. J Orthop Surg (Hong Kong), 2013, 21(3): 365-368.
10.	Al-Nakshabandi NA. Percutaneous vertebroplasty complications. Ann Saudi Med, 2013, 31(3): 294-297.
11.	Fehlings MG, Perrin RG. The timing of surgical intervention in the treatment of spinal cord injury: a systematic review of recent clinical evidence. Spine (Phlia Pa 1976), 2006, 31(11 Suppl): S28-35.
12.	Vaccaro AR, Daugherty RJ, Sheehan TP, et al. Neurologic outcome of early versus late surgery for cervical spinal cord injury. Spine (Phlia Pa 1976), 1997, 22(22): 2609-2613.
13.	周方. 胸腰椎骨折伴完全性脊髓损伤的手术时机选择. 中华创伤杂志, 2015, 31(6): 490.
14.	Fehlings MG, Perrin RG. The role and timing of early decompression for cervical spinal cord injury: update with a review of recent clinical evidence. Injury, 2005, 36 Suppl 2: B13-26.
15.	Lin BJ, Li CC, Ma HI. Intradural Cement Leakage After Percutaneous Vertebroplasty. Turk Neurosurg, 2015, 25(6): 940-942.
16.	施建党, 白雷, 丁惠强, 等. 不同术式治疗陈旧性胸腰椎骨折并脊髓损伤的疗效比较. 中国修复重建外科杂志, 2008, 22(11): 1327-1329.
17.	Wu AM, Zheng YJ, Lin Y, et al. Transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury. PloS One, 2014, 9(8): e105625.
18.	Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech, 2009, 22(2): 122-129.
19.	Ahn Y. Percutaneous endoscopic decompression for lumbar spinal stenosis. Expert Rev Med Devices, 2014, 11(6): 605-616.
20.	Li ZZ, Hou SX, Shang WL, et al. Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decom-pression for lateral recess stenosis through transforaminal approach: Technique notes and 2 years follow-up. Clin Neurol Neurosurg, 2016, 143: 90-94.
21.	Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteo-porotic compression fractures. J Bone Joint Surg (Br), 2003, 85(1): 83-89.
22.	Ahn SS, Kim SH, Kim DW. Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs. in-and-out-and-in): A Retrospective Comparative Study. J Korean Neurosurg Soc, 2015, 58(6): 539-546.

1. Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie, 1987, 33(2): 166-168.
2. Burton AW, Mendoza T, Gebhardt R, et al. Vertebral compression fracture treatment with vertebroplasty and kyphoplasty: experience in 407 patients with 1,156 fractures in a tertiary cancer center. Pain Med, 2011, 12(12): 1750-1757.
3. Bonnard E, Foti P, Kastler A, et al. Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience. Eur Radiol, 2017, 27(4): 1512-1516.
4. La Maida GA, Giarratana LS, Acerbi A, et al. Cement leakage: safety of minimally invasive surgical techniques in the treatment of multiple myeloma vertebral lesions. Eur Spine J, 2012, 21 Suppl 1: S61-S68.
5. Corcos G, Dbjay J, Mastier C, et al. Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors. Spine (Phlia Pa 1976), 2014, 39(5): E332-E338.
6. Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factors. Spine J, 2011, 11(9): 839-848.
7. Tomé-Bermejo F, Piñera AR, Duran-Álvarez C, et al. Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture. Spine, 2013, 9(Supplement): S90.
8. Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients. Medicine (Baltimore), 2016, 95(24): e3850.
9. Kulkarni AG, Shah SP, Deopujari CE. Epidural and intradural cement leakage following percutaneous vertebroplasty: a case report. J Orthop Surg (Hong Kong), 2013, 21(3): 365-368.
10. Al-Nakshabandi NA. Percutaneous vertebroplasty complications. Ann Saudi Med, 2013, 31(3): 294-297.
11. Fehlings MG, Perrin RG. The timing of surgical intervention in the treatment of spinal cord injury: a systematic review of recent clinical evidence. Spine (Phlia Pa 1976), 2006, 31(11 Suppl): S28-35.
12. Vaccaro AR, Daugherty RJ, Sheehan TP, et al. Neurologic outcome of early versus late surgery for cervical spinal cord injury. Spine (Phlia Pa 1976), 1997, 22(22): 2609-2613.
13. 周方. 胸腰椎骨折伴完全性脊髓损伤的手术时机选择. 中华创伤杂志, 2015, 31(6): 490.
14. Fehlings MG, Perrin RG. The role and timing of early decompression for cervical spinal cord injury: update with a review of recent clinical evidence. Injury, 2005, 36 Suppl 2: B13-26.
15. Lin BJ, Li CC, Ma HI. Intradural Cement Leakage After Percutaneous Vertebroplasty. Turk Neurosurg, 2015, 25(6): 940-942.
16. 施建党, 白雷, 丁惠强, 等. 不同术式治疗陈旧性胸腰椎骨折并脊髓损伤的疗效比较. 中国修复重建外科杂志, 2008, 22(11): 1327-1329.
17. Wu AM, Zheng YJ, Lin Y, et al. Transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury. PloS One, 2014, 9(8): e105625.
18. Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech, 2009, 22(2): 122-129.
19. Ahn Y. Percutaneous endoscopic decompression for lumbar spinal stenosis. Expert Rev Med Devices, 2014, 11(6): 605-616.
20. Li ZZ, Hou SX, Shang WL, et al. Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decom-pression for lateral recess stenosis through transforaminal approach: Technique notes and 2 years follow-up. Clin Neurol Neurosurg, 2016, 143: 90-94.
21. Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteo-porotic compression fractures. J Bone Joint Surg (Br), 2003, 85(1): 83-89.
22. Ahn SS, Kim SH, Kim DW. Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs. in-and-out-and-in): A Retrospective Comparative Study. J Korean Neurosurg Soc, 2015, 58(6): 539-546.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of percutaneous endoscopic technique in treatment of intraspinal cement leakage after percutaneous vertebroplasty

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content