Cargando…

Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report

INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and pen...

Descripción completa

Detalles Bibliográficos
Autores principales: Nagae, Masateru, Mikami, Yasuo, Mizuno, Kentaro, Harada, Tomohisa, Ikeda, Takumi, Tonomura, Hitoshi, Takatori, Ryota, Fujiwara, Hiroyoshi, Kubo, Toshikazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079337/
https://www.ncbi.nlm.nih.gov/pubmed/27759653
http://dx.doi.org/10.1097/MD.0000000000005178
_version_ 1782462547728793600
author Nagae, Masateru
Mikami, Yasuo
Mizuno, Kentaro
Harada, Tomohisa
Ikeda, Takumi
Tonomura, Hitoshi
Takatori, Ryota
Fujiwara, Hiroyoshi
Kubo, Toshikazu
author_facet Nagae, Masateru
Mikami, Yasuo
Mizuno, Kentaro
Harada, Tomohisa
Ikeda, Takumi
Tonomura, Hitoshi
Takatori, Ryota
Fujiwara, Hiroyoshi
Kubo, Toshikazu
author_sort Nagae, Masateru
collection PubMed
description INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained. It gradually increased in size and infiltrated lumbosacral vertebrae, causing him to present at age 35 years with increased low back pain. Image findings showed bone destruction in the vertebral bodies accompanied by neoplastic lesions. The left and right common iliac arteries and inferior vena cava were enclosed in the tumor on the anterior side of the vertebral bodies. Lumbosacral bone tumor due to direct extragonadal germ cell tumor infiltration was diagnosed. A 2-step operation was planned; first, fixation of the posterior side of the vertebral bodies, followed by tumor resection using an anterior transperitoneal approach, and spinal reconstruction using PMMA cement. After surgery, the PMMA cement gradually dislodged towards the anterior side and, 2 years 9 months after surgery, it had penetrated the retroperitoneum. The patient subsequently developed nausea and abdominal pain and was readmitted to hospital. The diagnosis was intestinal blockage with dislodged PMMA cement, and an operation was performed to remove the cement present in the small intestine. There was strong intra-abdominal adhesion, the peritoneum between the vertebral bodies and intestine could not be identified, and no additional treatment for vertebral body defects could be performed. After surgery, gastrointestinal symptoms resolved. CONCLUSION: Although this was a rare case, when using bone cement for vertebral body reconstruction, the way of anchoring for the cement must be thoroughly planned to assure no cement dislodgement can occur.
format Online
Article
Text
id pubmed-5079337
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-50793372016-11-03 Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report Nagae, Masateru Mikami, Yasuo Mizuno, Kentaro Harada, Tomohisa Ikeda, Takumi Tonomura, Hitoshi Takatori, Ryota Fujiwara, Hiroyoshi Kubo, Toshikazu Medicine (Baltimore) 7100 INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained. It gradually increased in size and infiltrated lumbosacral vertebrae, causing him to present at age 35 years with increased low back pain. Image findings showed bone destruction in the vertebral bodies accompanied by neoplastic lesions. The left and right common iliac arteries and inferior vena cava were enclosed in the tumor on the anterior side of the vertebral bodies. Lumbosacral bone tumor due to direct extragonadal germ cell tumor infiltration was diagnosed. A 2-step operation was planned; first, fixation of the posterior side of the vertebral bodies, followed by tumor resection using an anterior transperitoneal approach, and spinal reconstruction using PMMA cement. After surgery, the PMMA cement gradually dislodged towards the anterior side and, 2 years 9 months after surgery, it had penetrated the retroperitoneum. The patient subsequently developed nausea and abdominal pain and was readmitted to hospital. The diagnosis was intestinal blockage with dislodged PMMA cement, and an operation was performed to remove the cement present in the small intestine. There was strong intra-abdominal adhesion, the peritoneum between the vertebral bodies and intestine could not be identified, and no additional treatment for vertebral body defects could be performed. After surgery, gastrointestinal symptoms resolved. CONCLUSION: Although this was a rare case, when using bone cement for vertebral body reconstruction, the way of anchoring for the cement must be thoroughly planned to assure no cement dislodgement can occur. Wolters Kluwer Health 2016-10-21 /pmc/articles/PMC5079337/ /pubmed/27759653 http://dx.doi.org/10.1097/MD.0000000000005178 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 7100
Nagae, Masateru
Mikami, Yasuo
Mizuno, Kentaro
Harada, Tomohisa
Ikeda, Takumi
Tonomura, Hitoshi
Takatori, Ryota
Fujiwara, Hiroyoshi
Kubo, Toshikazu
Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title_full Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title_fullStr Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title_full_unstemmed Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title_short Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report
title_sort dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: a case report
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079337/
https://www.ncbi.nlm.nih.gov/pubmed/27759653
http://dx.doi.org/10.1097/MD.0000000000005178
work_keys_str_mv AT nagaemasateru dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT mikamiyasuo dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT mizunokentaro dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT haradatomohisa dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT ikedatakumi dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT tonomurahitoshi dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT takatoriryota dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT fujiwarahiroyoshi dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport
AT kubotoshikazu dislodgementandgastrointestinaltractpenetrationofbonecementusedforspinalreconstructionafterlumbosacralvertebraltumorexcisionacasereport