Li Ziquan, Yu Keyi, Chang Xiao, Cai Siyi, Gao Jun, Wang Yipeng
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China.
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China.
BMC Surg. 2020 Apr 15;20(1):74. doi: 10.1186/s12893-020-00733-8.
Percutaneous kyphoplasty (PKP) has become an important minimally invasive surgical technique for fracture stabilization and pain relief in patients with vertebral compression fractures. However, intraspinal cement leakage following PKP is a serious postoperative complication that can lead to morbidity and mortality.
We describe an uncommon case of epidural leakage of bone cement in an 81-year-old woman who underwent posterior lumbar decompression and fusion from L3-5 4 years prior and had an unremarkable postoperative course. The patient was admitted to Peking Union Medical College Hospital with complaints of muscle weakness and severe low back pain radiating to the left thigh 1 week after PKP of L5 due to an acute osteoporotic compression fracture. Computed tomographic imaging revealed massive leakage of cement into the spinal canal at L5-S1, and therefore, surgical decompression and removal of epidural cement were performed carefully without causing a dural tear. She improved remarkably and no neurologic deterioration was observed in the postoperative period during the one-year follow-up.
We present the rare reported case, to our knowledge, of epidural cement leakage after PKP at the segment of internal fixation and discuss the most likely etiologies and preventive measures for this condition.
经皮椎体后凸成形术（PKP）已成为治疗椎体压缩性骨折患者骨折固定和缓解疼痛的一项重要微创手术技术。然而，PKP术后椎管内骨水泥渗漏是一种严重的术后并发症，可导致发病和死亡。
我们描述了一例罕见的骨水泥硬膜外渗漏病例，患者为一名81岁女性，4年前接受了L3 - 5后路腰椎减压融合术，术后过程顺利。该患者因急性骨质疏松性压缩骨折在L5行PKP术后1周，因肌肉无力和严重的下背部疼痛放射至左大腿入住北京协和医院。计算机断层扫描成像显示L5 - S1水平有大量骨水泥渗漏至椎管内，因此，我们小心地进行了手术减压并清除硬膜外骨水泥，未造成硬脊膜撕裂。她恢复得非常好，在为期一年的随访期间术后未观察到神经功能恶化。
据我们所知，我们报告了这例罕见的PKP术后内固定节段硬膜外骨水泥渗漏病例，并讨论了这种情况最可能的病因及预防措施。
