Olbrycht Tomasz, Latka Kajetan, Kolodziej Waldemar, Krzeszowiec Tomasz, Latka Dariusz
Department of Neurosurgery, University of Opole, Opole, Poland.
J Korean Neurosurg Soc. 2025 Mar;68(2):127-136. doi: 10.3340/jkns.2024.0081. Epub 2025 Jan 23.
Cement-augmented pedicle screw instrumentation is a widely accepted method for managing osteoporotic fractures, but it carries inherent risks, particularly related to cement leakage and embolism. This study aimed to analyze a clinical case of complications following cement fixation and provide a detailed review of relevant literature. A 70-year-old patient underwent transpedicular screw instrumentation from L2-L4 with polymethyl methacrylate augmentation, which resulted in cement leakage into the spinal canal and subsequent pulmonary embolism. After revision surgery and conservative treatment for the embolism, the patient's condition stabilized, demonstrating that conservative measures can be effective in managing cement embolism. To complement this case, a comprehensive literature review was conducted to explore the causes, prevention, and treatment of complications related to cement augmentation. The findings support that while cement-augmented pedicle screw instrumentation remains a leading technique for osteoporotic fractures, the associated risks are manageable with proper treatment protocols. This study holds practical significance for healthcare professionals by highlighting both the risks and solutions associated with cement fixation, thus contributing to improved patient outcomes and the development of standardized treatment guidelines.
骨水泥强化椎弓根螺钉内固定术是治疗骨质疏松性骨折广泛认可的方法，但它存在固有风险，特别是与骨水泥渗漏和栓塞有关。本研究旨在分析1例骨水泥固定术后并发症的临床病例，并对相关文献进行详细综述。1例70岁患者接受了L2-L4经椎弓根螺钉内固定术并辅以聚甲基丙烯酸甲酯强化，结果导致骨水泥渗漏至椎管并继发肺栓塞。经过翻修手术及针对栓塞的保守治疗后，患者病情稳定，表明保守措施可有效处理骨水泥栓塞。为补充该病例，进行了全面的文献综述，以探讨与骨水泥强化相关并发症的原因、预防及治疗。研究结果支持，虽然骨水泥强化椎弓根螺钉内固定术仍是治疗骨质疏松性骨折的主要技术，但通过适当的治疗方案可控制相关风险。本研究通过强调与骨水泥固定相关的风险和解决方案，对医疗保健专业人员具有实际意义，从而有助于改善患者预后及制定标准化治疗指南。
