The eggshell technique for prevention of cement leakage during kyphoplasty.
Cement extravasation during kyphoplasty occurs between 4% and 9%, a much lower incidence than with vertebroplasty. However, because of the potential complications of cement in and around the spinal canal, any egress of cement outside the vertebral body is extremely concerning. Aborting the procedure will cease the extraosseous leakage and minimize potential immediate complications. However, the cavity will remain unfilled and the fracture unstable. Rather than aborting, we have devised a technique, called the eggshell technique, to manage the patient's fracture once extravasation is noted so that the procedure can be safely completed.
Greene
David L
DL
Spine Surgery Attending, Beth Israel Spine Institute, New York, NY, USA.
Isaac
Roman
R
Neuwirth
Michael
M
Bitan
Fabien D
FD
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects / Q000592:standards; D002484:Cementation / Q000009:adverse effects / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D050815:Fractures, Compression / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D016103:Spinal Fractures / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D001843:Bone Cements