Unusual Presentation of Infected Vertebroplasty with Delayed Cement Dislodgment in an Immunocompromised Patient: Case Report and Review of Literature

  • Wei-Che Lin
  • Chen-Hsiang Lee
  • Shih-Hao Chen
  • Chun-Chung Lui
Case Report

Abstract

Percutaneous vertebroplasty has been established as a safe and effective treatment for compression fractures of osteoporotic vertebrae. Complications of vertebroplasty, such as infection or anterior cement extrusion, are rare. Herein, we report an unusual presentation in an immunocompromised patient with an insidious infection of the disk. This infection resulted in dislodgment of the cement inferiorly and a compression fracture of the adjacent vertebra 6 months after vertebroplasty. We discuss the significance of this case and compare it with 7 others found in the literature.

Keywords

Cement Complication Infected spondylitis Polymethylmethacrylate Vertebroplasty 

References

  1. 1.
    Kallmes DF, Schweickert PA, Marx WF, et al. (2002) Vertebroplasty in the mid- and upper thoracic spine. AJNR Am J Neuroradiol 23:1117–1120PubMedGoogle Scholar
  2. 2.
    Jensen ME, Evans AJ, Mathis JM, et al. (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: Technical aspects. AJNR Am J Neuroradiol 18:1897–1904PubMedGoogle Scholar
  3. 3.
    Yu SW, Chen WJ, Lin WC, et al. (2004) Serious pyogenic spondylitis following vertebroplasty: A case report. Spine 29:E209–211PubMedCrossRefGoogle Scholar
  4. 4.
    Walker DH, Mummaneni P, Rodts GE Jr (2004) Infected vertebroplasty. Report of two cases and review of the literature. Neurosurg Focus 17:E6PubMedCrossRefGoogle Scholar
  5. 5.
    Vats HS, McKiernan FE (2006) Infected vertebroplasty: Case report and review of literature. Spine 31:E859–862PubMedCrossRefGoogle Scholar
  6. 6.
    Schmid KE, Boszczyk BM, Bierschneider M, et al. (2005) Spondylitis following vertebroplasty: A case report. Eur Spine J 14:895–899PubMedCrossRefGoogle Scholar
  7. 7.
    Alfonso Olmos M, Silva Gonzalez A, Duart Clemente J, et al. (2006) Infected vertebroplasty due to uncommon bacteria solved surgically: A rare and threatening life complication of a common procedure. Report of a case and a review of the literature. Spine 31:E770–773PubMedCrossRefGoogle Scholar
  8. 8.
    Lee BJ, Lee SR, Yoo TY (2002) Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: A case report. Spine 27:E419–422PubMedCrossRefGoogle Scholar
  9. 9.
    Francois K, Taeymans Y, Poffyn B, et al. (2003) Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: A case report. Spine 28:E424–425PubMedCrossRefGoogle Scholar
  10. 10.
    Wagner AL, Baskurt E (2006) Refracture with cement extrusion following percutaneous vertebroplasty of a large interbody cleft. AJNR Am J Neuroradiol 27:230–231PubMedGoogle Scholar
  11. 11.
    Tsai TT, Chen WJ, Lai PL, et al. (2003) Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty: A case report. Spine 28:E457–460PubMedCrossRefGoogle Scholar
  12. 12.
    Larsen HS, Mahon CR (2000) Staphylococci. In: Mahon CR, Manuselis G (eds) Textbook of diagnostic microbiology. WB Saunders, Philadelphia, pp 330–343Google Scholar
  13. 13.
    Lewis G (1997) Properties of acrylic bone cement: State of the art review. J Biomed Mater Res 38:155–182PubMedCrossRefGoogle Scholar
  14. 14.
    Lim TH, Brebach GT, Renner SM, et al. (2002) Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty. Spine 27:1297–1302PubMedCrossRefGoogle Scholar
  15. 15.
    Joly-Guillou ML (2005) Clinical impact and pathogenicity of Acinetobacter. Clin Microbiol Infect 11:868–873PubMedCrossRefGoogle Scholar
  16. 16.
    Lidwell OM (1986) Clean air at operation and subsequent sepsis in the joint. Clin Orthop:91–102Google Scholar
  17. 17.
    Buchholz HW, Elson RA, Heinert K (1984) Antibiotic-loaded acrylic cement: Current concepts. Clin Orthop:96–108Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Wei-Che Lin
    • 1
  • Chen-Hsiang Lee
    • 2
  • Shih-Hao Chen
    • 3
  • Chun-Chung Lui
    • 1
  1. 1.Department of Diagnostic RadiologyChang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of MedicineKaohsiungTaiwan
  2. 2.Division of Infectious Disease Chang Gung Memorial HospitalKaohsiung Medical Center, Chang Gung University College of MedicineKaohsiungTaiwan
  3. 3.Department of Orthopedics Chang Gung Memorial HospitalKaohsiung Medical Center, Chang Gung University College of MedicineKaohsiungTaiwan

Personalised recommendations