Navigation for tubular decompression of the l5 nerve root ganglion after cement leakage via a wiltse approach

Osteoporotic vertebral fractures are a widespread problem in the elderly population. In experienced hands, treatment procedures are safe and can be done in a minimally invasive fashion. Nevertheless, in rare cases, severe complications may occur. We present a case report of cement leakage after vert...

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Bibliographic Details
Published in:Asian journal of neurosurgery 2019-04, Vol.14 (2), p.565-567
Main Authors: Hartmann, Sebastian, Kavakebi, Pujan, Tschugg, Anja, Lener, Sara, Stocsits, Anna, Thomé, Claudius
Format: Article
Language:English
Subjects:
Case Report
CAT scans
Complications and side effects
Elderly
Fractures (Injuries)
Ganglion cysts
Orthopedic surgery
Osteoporosis
Paralysis
Tomography
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Summary:Osteoporotic vertebral fractures are a widespread problem in the elderly population. In experienced hands, treatment procedures are safe and can be done in a minimally invasive fashion. Nevertheless, in rare cases, severe complications may occur. We present a case report of cement leakage after vertebroplasty of L5 compressing the nerve root with neurological signs and radiculopathy. An 86-year-old female patient was introduced to our department with severe L5 nerve root radiculopathy and a foot flexion paresis after vertebroplasty of L5. Computed tomography (CT) of the lumbar spine revealed extraforaminal extravasation of cement around the nerve root causing significant compression. The patient underwent surgical revision using spinal navigation for skin incision, retractor placing, and verification of the cement extravasation. The cement plombage was removed, and the patient improved immediately. Sufficient decompression of the nerve root after cement leakage can be achieved using a spinal navigation setup in combination with intraoperative CT.
ISSN:1793-5482
2248-9614
DOI:10.4103/ajns.AJNS_253_18