Repeat Vertebroplasty for the Subsequent Refracture of Procedured Vertebra
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the 1st and 4th (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient’s pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.
Abstract
Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the 1st and 4th (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient’s pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.
참고문헌 (14)
- Silverman SL, "The clinical consequences of vertebral compression fracture", Bone, 13(Suppl 2), pp.S27~S31 (1992)
- Cortet B, "Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study", J Rheumatol, 26, pp.2222~2228 (1999)
- Barr JD, "Percutaneous vertebroplasty for pain relief and spinal stabilization", Spine (Phila Pa 1976), 25, pp.923~928 (2000)
- 최율, "경피적 척추체 성형술 후 발생한 폐색전증", The Korean Journal of Pain, 15(2), pp.190~193 (2002), 대한통증학회
- Kim DH, "Minimally invasive percutaneous spinal techniques", pp.259~276 (2011), Elsevier
- Lin WC, "Refractures in cemented vertebrae after percutaneous vertebroplasty: a retrospective analysis", Eur Spine J, 17, pp.592~599 (2008)
- Lin CC, "Recurrent pain after percutaneous vertebroplasty", AJR Am J Roentgenol, 194, pp.1323~1329 (2010)
- Belkoff SM, "The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior", Spine (Phila Pa 1976), 26, pp.1537~1541 (2001)
- Luo J, "Vertebroplasty: only small cement volumes are required to normalize stress distributions on the vertebral bodies", Spine (Phila Pa 1976), 34, pp.2865~2873 (2009)
- Kaufmann TJ, "The effects of cement volume on clinical outcomes of percutaneous vertebroplasty", AJNR Am J Neuroradiol, 27, pp.1933~1937 (2006)
- Al-Ali F, "Vertebroplasty: what is important and what is not", AJNR Am J Neuroradiol, 30, pp.1835~1839 (2009)
- Han IH, "MAGNETIC RESONANCE IMAGING FINDINGS OF SUBSEQUENT FRACTURES AFTER VERTEBROPLASTY", Neurosurgery, 64, pp.740~744 (2009), LIPPINCOTT WILLIAMS WILKINS
- He SC, "Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures", Spine (Phila Pa 1976), 33, pp.640~647 (2008)
- Dong Joon Kim, "The Proper Volume and Distribution of Cement Augmentation on Percutaneous Vertebroplasty", 대한신경외과학회지, 48(2), pp.125~128 (2010), 대한신경외과학회