Tardy Spinal Cord Compression without Bone Cement Leakage after Kyphoplasty: A Report of 3 Cases.
10.4184/jkss.2010.17.2.104
- Author:
Dong Ki AHN
1
;
Dea Jung CHOI
;
Hoon Seok PARK
;
Chang Wook YOO
Author Information
1. Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea. niceosu@freechal.com
- Publication Type:Case Report
- Keywords:
Kyphoplasty;
late spinal cord compression
- MeSH:
Congenital Abnormalities;
Conus Snail;
Decompression;
Fractures, Compression;
Kyphoplasty;
Neurologic Manifestations;
Spinal Canal;
Spinal Cord;
Spinal Cord Compression;
Spine
- From:Journal of Korean Society of Spine Surgery
2010;17(2):104-110
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: This is a case report. OBJECTIVE: We report here on three cases of late spinal cord compression without bone cement leakage after kyphoplasty from the view point of the common characteristics, the suspected etiologies and the performed treatments, and we propose a technique to prevent this kind of complication. SUMMARY OF THE LITERATURE REVIEW: Kyphoplasty is widely accepted as an effective and safe treatment for osteoporotic vertebral compression fracture (VCF). Complicated compression fractures and even bursting fractures with a compromised spinal canal are currently indicated for kyphoplasty. The wide spread application of kyphoplasty may be mainly due to reducing the complication rates associated with cement leakage and possible restoration, even though partially, of a vertebral kyphotic deformity. MATERIALS AND METHODS: we experienced three cases of newly emerged complications that caused delayed neurologic compromise after uneventful kyphoplasty without any immediate neurologic deficits. MR imaging was done to find the pathologic regions and surgical treatment was performed. RESULTS: Refracture of an augmented vertebra at the conus medullaris level can cause late occurring spinal cord compression without compromising the spinal canal. Posterior instrumentation and posterior fusion with posterior decompression were effective treatments. CONCLUSION: The anatomical peculiarity of the conus medullaris and the dynamic irritation of the spinal cord by a bone cement mass after refracture of an augmented vertebral body can be the causes of late spinal cord compression after kyphoplasty. The neurologic symptoms were treated by posterior decompression and fusion. This kind of complication can be prevented by injecting a sufficient amount of bone cement with a shape to support both endplates.
