Ye Yongsheng, Deng Fangyue, Feng Yonghong, Luo Linfeng, Li Henian, Zhuang Shabin
Department of Orthopedics, Dongguan Hospital of Traditional Chinese Medicine, Dongcheng District, Dongguan City, Guangdong Province 523000, China.
Department of Orthopedics, Dongguan Hospital of Traditional Chinese Medicine, Dongcheng District, Dongguan City, Guangdong Province 523000, China.
Int J Surg Case Rep. 2025 Sep;134:111727. doi: 10.1016/j.ijscr.2025.111727. Epub 2025 Jul 30.
Percutaneous vertebroplasty (PVP) is a minimally invasive procedure commonly used to alleviate pain and stabilise vertebral compression fractures caused by osteoporosis. Although generally safe, the procedure carries the risk of rare complications, such as epidural haematomas.
We present the case of a 67-year-old woman who underwent PVP for an abnormal pedicle structure associated with an osteoporotic compression fracture that led to the subsequently development of an epidural haematoma. The patient presented with severe back pain following a fall at home. Imaging revealed a T12 vertebral compression fracture with marked collapse and posterior wall involvement. The pain and functional impairment persisted despite conservative management. After polymethylmethacrylate injection into the fractured vertebrae, the patient reported unbearable lower back pain and bilateral lower limb weakness, which progressed to paraplegia.
Magnetic resonance imaging of the spine revealed bilateral epidural haematomas at T11-T12, causing significant spinal cord compression. Urgent surgical decompression was performed to relieve nerve compression. Neurological symptoms improved gradually.
This case highlights the importance of early diagnosis and management of the complications of PVP, including epidural haematoma.
经皮椎体成形术(PVP)是一种常用于缓解骨质疏松引起的疼痛并稳定椎体压缩性骨折的微创手术。尽管该手术总体安全,但仍存在罕见并发症的风险,如硬膜外血肿。
我们报告一例67岁女性病例,该患者因与骨质疏松性压缩骨折相关的椎弓根结构异常接受了PVP手术,术后并发硬膜外血肿。患者在家中跌倒后出现严重背痛。影像学检查显示T12椎体压缩性骨折,伴有明显塌陷和后壁受累。尽管采取了保守治疗,疼痛和功能障碍仍持续存在。在向骨折椎体注入聚甲基丙烯酸甲酯后,患者报告下背部疼痛难忍且双侧下肢无力,随后发展为截瘫。
脊柱磁共振成像显示T11 - T12水平双侧硬膜外血肿,导致严重脊髓受压。紧急进行了手术减压以缓解神经压迫。神经症状逐渐改善。
该病例突出了早期诊断和处理PVP并发症(包括硬膜外血肿)的重要性。