A novel approach to treatment of unexpected vertebroplasty complication.
We report a novel approach to treatment of an unexpected complication of vertebroplasty. During initial positioning of transpedicular vertebroplasty needles in a 73-year-old woman, we encountered unexpected ease of needle advancement resulting in progression of the needle through the anterior cortex of the thoracic vertebral body. The transpedicular needle advanced into the mediastinum and, presumably, the adventitia of the descending thoracic aorta. Administration of polymethylmethacrylate cement was performed to tamponade bleeding at the time of the procedure and to reduce the risk of potential delayed bleeding complications within the mediastinum. The treatment was successful and the patient had no immediate or delayed complications as a result of the unintended needle advancement.
Hard
Jonathan M
JM
Department of Radiology, Providence Hospital, 16001 West Nine Mile Road, Southfield, MI 48075, USA. jonathan_hard2001@yahoo.com
Gonda
Roger L
RL
Kadakia
Saumil R
SR
D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries*; D001843:Bone Cements / Q000627:therapeutic use*; D003287:Contrast Media; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D010024:Osteoporosis / Q000150:complications; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D015641:Radiography, Interventional; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000295:instrumentation*
D001843:Bone Cements; D003287:Contrast Media; D019904:Polymethyl Methacrylate