• Spine · Oct 2002

    Review Case Reports

    Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: a case report.

    • Bong-Jin Lee, Sung-Rak Lee, and Tae-Yeul Yoo.
    • Department of Orthopaedic Surgery, Halla General Hospital, Jeju, South Korea. BJLee@hallahosp.co.kr
    • Spine. 2002 Oct 1; 27 (19): E419-22.

    Study DesignA case report and review of the literature are presented.ObjectiveTo present the first case of paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate in osteoporotic compression fracture.Summary Of Background DataComplications of percutaneous vertebroplasty with polymethylmethacrylate (PMMA) for the treatment of osteoporotic compression fracture were found to be rare and minor, except in two cases of major neurologic complication.MethodsThe reported case is that of a 66-year-old woman with multilevel vertebral osteopenia and compression fractures. Percutaneous vertebroplasty using polymethylmethacrylate was performed at three vertebral bodies (L2, L1, and T11) using careful techniques including venography, large cannula, proper preparation and amount of polymethylmethacrylate, and continuous visualization with fluoroscopy.ResultsImmediately after surgery, the patient had complete motor and sensory deficits at T11. Computed tomography scan showed spinal cord compression caused by venous leakage of polymethylmethacrylate. In anticipation of recovery from paraplegia, posterior decompression was performed from L2 to T10.ConclusionsPercutaneous vertebroplasty with polymethylmethacrylate is not as simple and risk free as advocated in the literature. Careful safeguards and modifications are needed for the procedure, and new and physiologic material could be substituted for polymethylmethacrylate.

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