• Yu-Duan Tsai, Po-Chau Liliang, Han-Jung Chen, Kang Lu, Cheng-Loong Liang, and Kuo-Wei Wang.
• Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
• Spine. 2010 Feb 15;35(4):E134-6.

Study DesignCase report.ObjectiveTo report a rare case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty.Summary Of Background DataVertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. Here, we describe a severe complication associated with this procedure; a similar complication has not been reported previously.MethodsA 63-year-old woman suffered from persistent severe back pain that radiated to both sides of the chest wall 1 week before medical consultation. Magnetic resonance imaging analysis of the thoracolumbar spine revealed a pathologic fracture in the body of the T9 and T10 vertebrae, with retropulsion into the spinal canal and compression of the spinal cord at the T10 level. We performed decompressive laminectomy of the T9-10 vertebrae with tumor biopsy and vertebroplasty.ResultsImmediately after the operation, the patient experienced paraplegia and loss of sensitivity to pain/temperature; however, deep pressure sensation and 2-point discrimination below the umbilicus (T10 level) were preserved. Computed tomography scans showed the presence of PMMA in T9 and T10, with opacification of the paravertebral vessels, the left intercostal artery at the T10 level, and a segment of the anterior spinal artery at the T10-11 level.ConclusionWe present the first report describing a case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty. The severity of this complication warrants that surgeons should inform patients of the same while obtaining their consent for vertebroplasty.

34 keywords...

hide…