Spinal cord compression after percutaneous kyphoplasty for metastatic compression fracture
2013; Elsevier BV; Volume: 13; Issue: 7 Linguagem: Inglês
10.1016/j.spinee.2013.02.045
ISSN1878-1632
AutoresSean Esmende, Alan H. Daniels, Mark A. Palumbo,
Tópico(s)Spinal Hematomas and Complications
ResumoA 65-year-old man with a history of metastatic squamous cell carcinoma of the tongue underwent a percutaneous kyphoplasty at an outside hospital for a painful T9 metastatic compression fracture. Immediately after the procedure, the patient developed saddle anesthesia and progressive bilateral lower extremity numbness and weakness. He was then transferred to our hospital for further care. Computed tomography and magnetic resonance imaging revealed kyphoplasty cement within the T9 vertebral body (Fig. 1) with retropulsion of tumor mass into the ventral spinal canal (Fig. 2). The patient underwent emergent posterolateral decompression with T9 vertebrectomy, anterior reconstruction T8–T10, and posterior instrumented spinal fusion (Fig. 3). Histopathological examination confirmed the diagnosis of metastatic squamous cell carcinoma. Postoperatively, the patient regained full strength and sensation along with the ability to ambulate. Fig. 2Sagittal and axial T2-weighted magnetic resonance imaging view of the thoracic spine after kyphoplasty with cement at T9 and neoplastic tissue causing ventral spinal cord compression. View Large Image Figure Viewer Download Hi-res image Fig. 3Intraoperative sagittal and anteroposterior radiograph: T9 vertebrectomy, anterior cage reconstruction, and posterior instrumentation. View Large Image Figure Viewer Download Hi-res image
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