Zhao Xiao-Ming, Lou Xiao-Xiao, Chen An-Fa, Zhang Yin-Gang
Department of Orthopaedics of the First Affiliated Hospital, Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Surg. 2023 Jan 6;9:1048107. doi: 10.3389/fsurg.2022.1048107. eCollection 2022.
In recent years, as the concept of minimally invasive treatment has been accepted by the majority of patients, the application of percutaneous vertebroplasty in osteoporotic vertebral compression fractures has gradually increased, and research on the adverse complications of bone cement leakage has gradually deepened.
Here, we report a rare case of acute pancreatitis after vertebroplasty. The patient had no previous history of pancreatitis and presented with obvious abdominal pain after vertebroplasty. Abdominal CT examination revealed that the leaking bone cement penetrated the anterior wall of the L1 vertebral body into the diaphragm, and the heat released by the polymerization reaction caused inflammation and damage to the adjacent pancreas, resulting in poor blood flow to the pancreatic tissue and leading to acute pancreatitis. Early postoperative symptomatic treatment was given to the patient, and the corresponding symptoms were gradually relieved. During postoperative follow-up, the leaking cement did not degrade, but the patient had no symptoms.
Lesions of adjacent organs caused by bone cement leakage are rare, and clinicians often ignore the association between such complications and vertebroplasty. This case report will provide guidance and a reference for clinicians.
近年来,随着微创治疗理念被广大患者所接受,经皮椎体成形术在骨质疏松性椎体压缩骨折中的应用逐渐增多,对骨水泥渗漏不良并发症的研究也逐渐深入。
在此,我们报告1例椎体成形术后发生急性胰腺炎的罕见病例。该患者既往无胰腺炎病史,椎体成形术后出现明显腹痛。腹部CT检查显示,渗漏的骨水泥穿透L1椎体前壁进入膈肌,聚合反应释放的热量引起邻近胰腺的炎症和损伤,导致胰腺组织血流不畅,进而引发急性胰腺炎。术后早期对患者进行了对症治疗,相应症状逐渐缓解。术后随访期间,渗漏的骨水泥未降解,但患者无症状。
骨水泥渗漏引起的邻近器官损伤较为罕见,临床医生常忽视此类并发症与椎体成形术之间的关联。本病例报告将为临床医生提供指导和参考。