Revision surgery after vertebroplasty or kyphoplasty.
BACKGROUND
We wanted to investigate the leading cause of failed vertebroplasty or kyphoplasty.


METHODS
Twelve patients (10 females and 2 males) who underwent revision surgery after vertebroplasty or kyphoplasty were included. In 4 cases, vertebroplasty was done for two or more levels. Six cases with kyphoplasty were included. Through the retrospective review of the radiographic studies and medical record, we analyzed the etiology of the revision surgery.


RESULTS
Uncontrolled back pain was the main clinical presentation. In 4 cases, neurological symptoms were noted, including one case with conus medullaris syndrome. The average time to the revision surgery after vertebroplasty or kyphoplasty was 15 months. Infection (4 cases) and progressive kyphosis with collapse (8 cases) were the causes for the revision. A solid pattern of inserted bone cement and bone resorption around the cement were noted in the all cases with progressive collapse and kyphosis.


CONCLUSIONS
Infection, misdiagnosis and progressive kyphosis were causes of the revision surgery after vertebroplasty and kyphoplasty. A solid pattern of accumulation of bone cement and peri-cement bone resorption might be related with the progressive collapse.
Department of Orthopaedic Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
Kee-Yong
KY
Ha
Ki-Won
KW
Kim
Young-Hoon
YH
Kim
In-Soo
IS
Oh
Sang-Won
SW
Park
D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D012086:Reoperation; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D017211:Treatment Failure; D054854:Vertebroplasty / Q000009:adverse effects; D055815:Young Adult
D001843:Bone Cements