Rustagi Tarush, Bourekas Eric, Mendel Ehud
Ohio State University Wexner Medical Center and Arthur G. James Cancer Hospital, Columbus, Ohio.
Indian Spinal Injuries Centre, New Delhi, India.
Int J Spine Surg. 2020 Aug;14(4):594-598. doi: 10.14444/7079. Epub 2020 Jul 31.
Percutaneous vertebroplasty (PVP) is an effective procedure for painful pathological vertebral fractures. High-viscosity cement is the preferred choice for vertebroplasty given its low risk of extravasation. We describe here 2 cases of high-viscosity cement vertebroplasty in large lytic defects and associated complications.
Case 1 describes PVP in an 89-year-old male patient with L1 pathological fracture from prostrate metastasis. Case 2 describes PVP in a 68-year-old male with T7 and T8 vertebral fractures from multiple myeloma. In both cases, high-viscosity cement was used to fill large lytic cavities. This resulted in poor interdigitation of the cement with the trabeculae forming an unstable floating cement ball and dangerous retrieval of the cement trocar needle. The implications of this occurrence have been described.
High-viscosity-cement vertebroplasty in large lytic defects needs to be done with caution. The potential occurrence of poor cement interdigitation and the following complications can be catastrophic, and caution must be used.
经皮椎体成形术（PVP）是治疗疼痛性病理性椎体骨折的有效方法。高粘度骨水泥因其渗漏风险低而成为椎体成形术的首选。我们在此描述2例在大的溶骨性缺损中使用高粘度骨水泥进行椎体成形术及相关并发症的病例。
病例1为一名89岁男性患者，因前列腺转移导致L1病理性骨折，接受了PVP治疗。病例2为一名68岁男性，因多发性骨髓瘤导致T7和T8椎体骨折，接受了PVP治疗。在这两个病例中，均使用高粘度骨水泥填充大的溶骨性空洞。这导致骨水泥与小梁的相互交错不良，形成不稳定的漂浮骨水泥球，并在取出骨水泥套管针时出现危险情况。本文描述了这种情况的影响。
在大的溶骨性缺损中进行高粘度骨水泥椎体成形术时需谨慎。骨水泥相互交错不良及随之而来的并发症可能是灾难性的，必须谨慎操作。
