J Korean Orthop Assoc.  2020 Feb;55(1):90-94. 10.4055/jkoa.2020.55.1.90.

Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture

• Park SJ
• Park MH
• Park JW
• Cho KJ

• KMID: 2470774
• DOI: http://doi.org/10.4055/jkoa.2020.55.1.90

Abstract

Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Keyword

compression fracture; pathologic fracture; kyphoplasty; cauda equina syndrome

MeSH Terms

Cauda Equina*
Female
Fractures, Compression*
Fractures, Spontaneous
Hand
Humans
Kyphoplasty*
Magnetic Resonance Imaging
Polyradiculopathy*
Spinal Canal

Figure

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  Figure 1 Sagittal (A), axial (B) computed tomography scan showed pathologic fracture with osteolysis at L5 vertebral body, suggesting a metastatic tumor.

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  Figure 2 Sagittal T2-weighted (A), axial T2-weighted (B) spinal magnetic resonance imaging show a contrast-enhancing mass at L5 vertebral body.

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  Figure 3 Lumbar spine anteroposterior (A), lateral (B) radiographs showed cement within V5 vertebral body with cement leakage to L4–5 disc space.

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  Figure 4 Sagittal T2-weighted (A), axial T2-weighted (B) magnetic resonance imaging show retropulsion of neoplastic tissue with significant epidural compression of dural sac of L5 body.

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  Figure 5 Lumbar spine anteroposterior (A), lateral (B) radiographs showing pedicle screw instrumentation in L45S1.

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