Liao Wensheng, Hou Zhenxing, Gao Yanzheng
Department of Spine and Spinal Cord Surgery, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
Department of Spine and Spinal Cord Surgery, Henan University People's Hospital, Zhengzhou, People's Republic of China.
Int Med Case Rep J. 2025 Aug 22;18:1063-1069. doi: 10.2147/IMCRJ.S535207. eCollection 2025.
Osteoporotic vertebral compression fracture (OVCF) is a common complication of osteoporosis, often resulting in vertebral collapse, chronic pain, and increased mortality. Vertebroplasty (VP) is a minimally invasive procedure used to alleviate pain by injecting bone cement into fractured vertebrae. However, bone cement leakage is a frequent complication, typically occurring in the extradural space with minimal clinical symptoms. In contrast, intradural cement leakage is rare but can lead to severe consequences such as neural compression and neurological deficits, necessitating urgent intervention. We present a case of a 70-year-old woman who developed intradural cement leakage after VP for a T12 compression fracture. The patient experienced immediate lower limb weakness, numbness, sensory loss, and urinary/defecation dysfunction following the procedure. MRI revealed posterior cement leakage compressing the spinal cord at the T12 level. She underwent surgical decompression and cement removal at our institution, including posterior fixation from T11 to L1, total laminectomy, and durotomy. Due to intraoperative neurophysiological monitoring, complete removal of intradural cement was not achieved. Postoperatively, the patient showed gradual improvement in lower limb muscle strength and sensory function, with near-complete recovery at one-month follow-up. Consequently, to prevent intradural cement leakage, surgeons must be vigilant about this rare complication and perform precise puncture and cautious cement injection. In cases of catastrophic leakage, prompt cement removal and thorough spinal canal decompression are essential. Preoperative CT imaging is crucial for confirming intradural leakage and planning precise surgery to reduce risks and improve outcomes.
骨质疏松性椎体压缩骨折（OVCF）是骨质疏松症的常见并发症，常导致椎体塌陷、慢性疼痛和死亡率增加。椎体成形术（VP）是一种微创手术，通过向骨折椎体注射骨水泥来缓解疼痛。然而，骨水泥渗漏是一种常见的并发症，通常发生在硬膜外间隙，临床症状轻微。相比之下，硬膜内骨水泥渗漏很少见，但可导致严重后果，如神经受压和神经功能缺损，需要紧急干预。我们报告一例70岁女性，在T12椎体压缩骨折行VP术后发生硬膜内骨水泥渗漏。术后患者立即出现下肢无力、麻木、感觉丧失及排尿/排便功能障碍。MRI显示后方骨水泥渗漏压迫T12水平脊髓。她在我院接受了手术减压及骨水泥清除，包括T11至L1后路固定、全椎板切除术及硬脊膜切开术。由于术中神经电生理监测，硬膜内骨水泥未完全清除。术后患者下肢肌力和感觉功能逐渐改善，随访1个月时接近完全恢复。因此，为防止硬膜内骨水泥渗漏，外科医生必须警惕这种罕见并发症，进行精确穿刺并谨慎注射骨水泥。在发生灾难性渗漏的情况下，及时清除骨水泥并彻底减压椎管至关重要。术前CT成像对于确认硬膜内渗漏及规划精确手术以降低风险和改善预后至关重要。
