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Percutaneous Extraction of Cement Leakage After Vertebroplasty Under CT and Fluoroscopy Guidance: A New Technique

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Abstract

Purpose

We report a new minimally invasive technique of extraction of cement leakage following percutaneous vertebroplasty in adults.

Methods

Seven adult patients (five women, two men; mean age: 81 years) treated for vertebral compression fractures by percutaneous vertebroplasty had cement leakage into perivertebral soft tissues along the needle route. Immediately after vertebroplasty, the procedure of extraction was performed under computed tomography (CT) and fluoroscopy guidance: a Chiba needle was first inserted using the same route as the vertebroplasty until contact was obtained with the cement fragment. This needle was then used as a guide for an 11-gauge Trocar t’am (Thiebaud, France). After needle withdrawal, a 13-gauge endoscopy clamp was inserted through the cannula to extract the cement fragments. The whole procedure was performed under local anesthesia.

Results

In each patient, all cement fragments were withdrawn within 10 min, without complication.

Conclusions

This report suggests that this CT- and fluoroscopy-guided percutaneous technique of extraction could reduce the rate of cement leakage-related complications.

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References

  1. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33(2):166–168

    PubMed  CAS  Google Scholar 

  2. Barragan-Campos HM, Vallee JN, Lo D et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238(1):354–362

    Article  PubMed  Google Scholar 

  3. Cotten A, Dewatre F, Cortet B et al (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 200(2):525–530

    PubMed  CAS  Google Scholar 

  4. Kelekis AD, Martin JB, Somon T, Wetzel SG, Dietrich PY, Ruefenacht DA (2003) Radicular pain after vertebroplasty: compression or irritation of the nerve root? Initial experience with the “cooling system.”. Spine (Phila Pa 1976) 28(14):E265–E269

    Google Scholar 

  5. Padovani B, Kasriel O, Brunner P, Peretti-Viton P (1999) Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJNR Am J Neuroradiol 20(3):375–377

    PubMed  CAS  Google Scholar 

  6. Teng MM, Cheng H, Ho DM, Chang CY (2006) Intraspinal leakage of bone cement after vertebroplasty: a report of 3 cases. AJNR Am J Neuroradiol 27(1):224–229

    PubMed  CAS  Google Scholar 

  7. Basile A, Cavalli M, Fiumara P et al (2011) Vertebroplasty in multiple myeloma with osteolysis or fracture of the posterior vertebral wall. Usefulness of a delayed cement injection. Skeletal Radiol 40(7):913–919

    Article  PubMed  Google Scholar 

  8. Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 15(1):83–86

    PubMed  CAS  Google Scholar 

  9. Jin YJ, Yoon SH, Park KW et al (2011) The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications. Spine (Phila Pa 1976) 36(12):E761–E772

    Article  Google Scholar 

  10. Lee IJ, Choi AL, Yie MY et al (2010) CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty. Acta Radiol 51(6):649–654

    Article  PubMed  Google Scholar 

  11. Lin EP, Ekholm S, Hiwatashi A, Westesson PL (2004) Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol 25(2):175–180

    PubMed  Google Scholar 

  12. Chen JK, Lee HM, Shih JT, Hung ST (2007) Combined extraforaminal and intradiscal cement leakage following percutaneous vertebroplasty. Spine (Phila Pa 1976) 32(12):E358–E362

    Article  Google Scholar 

  13. Anselmetti GC, Zoarski G, Manca A et al (2008) Percutaneous vertebroplasty and bone cement leakage: clinical experience with a new high-viscosity bone cement and delivery system for vertebral augmentation in benign and malignant compression fractures. Cardiovasc Interv Radiol 31(5):937–947

    Article  Google Scholar 

  14. Martin JB, Wetzel SG, Seium Y et al (2003) Percutaneous vertebroplasty in metastatic disease: transpedicular access and treatment of lysed pedicles–initial experience. Radiology 229(2):593–597

    Article  PubMed  Google Scholar 

  15. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18(10):1897–1904

    PubMed  CAS  Google Scholar 

  16. Thomas J, Sinclair-Smith B, Bloomfield D, Davachi A (1964) Nonsurgical retrieval of a broken segment of steel spring guide from the right atrium and inferior vena cava. Circulation 30:106–108

    Article  PubMed  CAS  Google Scholar 

  17. Gabelmann A, Kramer S, Gorich J (2001) Percutaneous retrieval of lost or misplaced intravascular objects. AJR Am J Roentgenol 176(6):1509–1513

    PubMed  CAS  Google Scholar 

  18. O’Shea SJ, Martin DF (2003) Percutaneous removal of retained calculi from the abdomen. Cardiovasc Interv Radiol 26(1):81–84

    Article  Google Scholar 

  19. Ojanguren A, Doenz F, Qanadli SD et al (2005) Percutaneous extraction of retained biliary T-tubes: a new technique. J Vasc Interv Radiol 16(7):1033–1036

    Article  PubMed  Google Scholar 

  20. Amoretti N, Hauger O, Marcy PY et al (2010) Foreign body extraction from soft tissue by using CT and fluoroscopic guidance: a new technique. Eur Radiol 20(1):190–192

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Nicolas Amoretti.

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Amoretti, N., Huwart, L. Percutaneous Extraction of Cement Leakage After Vertebroplasty Under CT and Fluoroscopy Guidance: A New Technique. Cardiovasc Intervent Radiol 35, 1492–1495 (2012). https://doi.org/10.1007/s00270-012-0414-0

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  • DOI: https://doi.org/10.1007/s00270-012-0414-0

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