Ratliff J, Nguyen T, Heiss J
Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD 20892, USA.
Spine (Phila Pa 1976). 2001 Jul 1;26(13):E300-2. doi: 10.1097/00007632-200107010-00021.
Case report and literature review.
Clinicians use methylmethacrylate vertebroplasty to treat vertebral hemangiomas, metastases, and osteoporotic fractures. Cement may leak out of the vertebral body and compress the adjacent spinal cord and nerve roots. We review a case of nerve-root and cord compression from methylmethacrylate extrusion during vertebroplasty.
A 50-year-old female presented with disabling thoracic back pain. A metastasis to T1 was discovered, with collapse of the vertebral body but without cord compression. Methylmethacrylate vertebroplasty was performed. After injection, portable computed tomography (CT) showed a leakage of methylmethacrylate into the C8 and T1 foramina and spinal canal. Radiculopathy and myelopathy developed. Surgical decompression using the anterior approach was necessary.
Case report.
Early surgical intervention decompressed the neural elements and relieved the neurological deficits.
Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.
病例报告及文献综述。
临床医生使用甲基丙烯酸甲酯椎体成形术治疗椎体血管瘤、转移瘤及骨质疏松性骨折。骨水泥可能会从椎体中渗漏出来，压迫相邻的脊髓和神经根。我们回顾了一例椎体成形术中甲基丙烯酸甲酯挤出导致神经根和脊髓受压的病例。
一名50岁女性因严重的胸背部疼痛就诊。发现T1椎体有转移瘤，椎体塌陷但无脊髓受压。遂行甲基丙烯酸甲酯椎体成形术。注射后，便携式计算机断层扫描（CT）显示甲基丙烯酸甲酯渗漏至C8和T1椎间孔及椎管内。出现了神经根病和脊髓病。需要采用前路手术减压。
病例报告。
早期手术干预使神经结构得到减压，神经功能缺损得以缓解。
甲基丙烯酸甲酯椎体成形术的神经并发症需要脊柱外科医生积极参与患者的评估和管理。
