Question:We just came from the orthopedic surgeon's office where my husband was told he has a vertebral compression fracture. He's going to have a vertebroplasty. The nurse reviewed all of the possible complications. It seemed like she talked the most about cement leakage. How often does this happen, and why is it such a problem?
Answer:Vertebroplasty is the injection of a liquid cement that hardens quickly and holds the bone together. The procedure is fairly simple but requires a skilled surgeon. Complications can occur if the cement leaks out of the bone and into the surrounding spaces.
The biggest problem occurs if the cement leaks into the area where the spinal cord or spinal nerves are located. In such cases, mild to severe neurologic damage can occur.
The risk of leakage varies from three to 74 per cent. Surgeons and researchers are working together to find ways to reduce this problem. New techniques and tools for cement delivery are underway. Injecting the cement slowly under low pressure helps.
Studies show that the vertebroplasty method uses less cement and only requires injection from one side. These two factors may help reduce cement leakage and fractures of adjacent bones.
Careful surgical technique by a qualified surgeon should minimize this problem. The experienced surgeon uses fluoroscopy (special X-ray imaging) to see the extent and direction the cement is flowing. Any time cement leakage is seen, the procedure should be stopped immediately.Bruce M. Frankel, MD, et al. Percutaneous Vertebral Augmentation: An Elevation in Adjacent-Level Fracture Risk in Kyphoplasty as Compared with Vertebroplasty. In The Spine Journal. November 2007. Vol. 7. No. 5. Pp. 575-582.
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