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The Journal of Bone and Joint Surgery (American) 83:1070-1073 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Case Report

Major Neurological Complications Following Percutaneous Vertebroplasty with Polymethylmethacrylate

A Case Report

Kevin D. Harrington, MD

Investigation performed at the California Pacific Medical Center, San Francisco, California
Kevin D. Harrington, MD
3838 California Street, Suite 516, San Francisco, CA 94118

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.


   Introduction
 
The technique of percutaneous vertebroplasty was developed by Galibert et al.1 to manage refractory vertebral-body compression fractures secondary to osteoporosis. It involves injection of polymethylmethacrylate into the collapsed vertebral body in order to augment the deficient bone and to relieve pain. It also requires placement of a large-bore (10-gauge) spinal needle under fluoroscopic guidance into each affected vertebral body through a posterior bilateral transpedicular approach2.

Vertebroplasty has been performed for approximately 200 patients with osteoporotic vertebral collapse2-10, but not a single instance of spinal-cord compromise or major extrusion of polymethylmethacrylate into the spinal canal has been described. I am aware of only one instance in which a peripheral neuropathy was attributed to the leakage of cement into a neural foramen, and this transient complication resolved spontaneously3.

The current case report documents the catastrophic extrusion of polymethylmethacrylate, both into the spinal canal and into neural foramina at multiple . . . [Full Text of this Article]


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