Neurológia pre prax 1/2011

Complications of percutaneous kyphoplasty

A 39-year-old female patient was admitted to our department for traumatic compression fracture of the Th9 vertebral body. The clinical finding as well as MRI finding favoured percutaneous kyphoplasty. A rare complication – cement leakage into the soft paravertebral tissues – occurred during this procedure. Because of the declared properties of the implanted material, particularly the biodegradability of bone cement, observation of the patient was carried out. Over the course of days, progressive back pain and difficult breathing occurred. Imaging methods revealed progressive pleuropulmonary changes. A circumscribed inflammatory focus and pleural effusion with subsequent respiratory insufficiency developed. The patient was indicated for abscess evacuation, extirpation of the cement from the osseous tissue and subsequent thoracic drainage. However, the patient’s condition continued to deteriorate as did the imaging finding and a second revision was necessary which involved pulmonary lobe decortication. Following this procedure, the further clinical course was favourable.

Keywords: complication, percutaneous kyphoplasty, biodegradable bone cement, pleural effusion, empyema, pulmonary decortication, thoracotomy.