J Korean Pain Soc.
2003 Dec;16(2):267-272.
Benign Cement Leakage after Kyphoplasty: A report of 2 cases
- Affiliations
-
- 1Pain Clinic, Department of Anesthesiology, CHA General Hospital, Seongnam, Korea. pandjo@mdhouse.com
- 2Department of Anesthesiology, CHA General Hospital, Seongnam, Korea.
Abstract
- Vertebral fractures are one of the most common complications of osteoporosis, and as a result, intractable pain can persist in some patients. Percutaneous vertebroplasty and kyphoplasty are employed to inject bone cement into the compressed vertebral body in osteoporotic vertebral compression fractures, with persistent pain for several weeks. The limiting factor with a percutaneous vertebroplasty is the extravertebral extravasation of the cement when injected. This limiting factor of kyphoplasty is overcome by restoring the height of the vertebral body, via an inflatable bone tamp and injecting a cement with higher viscosity. Leakage of cement from kyphoplasty is rare, but it is still possible for this to occur. The complications from the cement leakage range from asymptomatic to serious symptoms, but only a few cases have been reported. Recently, two cases of relatively large leakages of cement, into the epidural space and erector spinae muscle, were reported after kyphoplasty. However, these two cases had no specific symptoms and followed a benign nature. The importance of cement with the proper viscosity, patient selection, technical experience of the procedure and the quality of fluoroscopic viewing during the cement injection have all been recognized.