Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: a case report.
METHODS
A case report and review of the literature are presented.


OBJECTIVE
To present the first case of paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate in osteoporotic compression fracture.


BACKGROUND
Complications of percutaneous vertebroplasty with polymethylmethacrylate (PMMA) for the treatment of osteoporotic compression fracture were found to be rare and minor, except in two cases of major neurologic complication.


METHODS
The reported case is that of a 66-year-old woman with multilevel vertebral osteopenia and compression fractures. Percutaneous vertebroplasty using polymethylmethacrylate was performed at three vertebral bodies (L2, L1, and T11) using careful techniques including venography, large cannula, proper preparation and amount of polymethylmethacrylate, and continuous visualization with fluoroscopy.


RESULTS
Immediately after surgery, the patient had complete motor and sensory deficits at T11. Computed tomography scan showed spinal cord compression caused by venous leakage of polymethylmethacrylate. In anticipation of recovery from paraplegia, posterior decompression was performed from L2 to T10.


CONCLUSIONS
Percutaneous vertebroplasty with polymethylmethacrylate is not as simple and risk free as advocated in the literature. Careful safeguards and modifications are needed for the procedure, and new and physiologic material could be substituted for polymethylmethacrylate.
Lee
Bong-Jin
BJ
Department of Orthopaedic Surgery, Halla General Hospital, Jeju, South Korea. BJLee@hallahosp.co.kr
Lee
Sung-Rak
SR
Yoo
Tae-Yeul
TY
D000368:Aged; D019299:Decompression, Surgical; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000601:surgery; D010024:Osteoporosis / Q000150:complications; D010264:Paraplegia / Q000175:diagnosis* / Q000209:etiology*; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000009:adverse effects*; D012086:Reoperation; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology*; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy; D013904:Thoracic Vertebrae / Q000187:drug effects / Q000601:surgery; D014057:Tomography, X-Ray Computed
D019904:Polymethyl Methacrylate