Thoracic Epidural Hematoma Complicating Vertebroplasty

Patient: Female, 64 Final Diagnosis: Thoracic epidural hematoma Symptoms: Paraplegia Medication: — Clinical Procedure: Thoracal hemilaminectomy Specialty: Neurosurgery OBJECTIVE: Diagnostic/therapeutic accidents BACKGROUND: Percutaneous vertebroplasty procedures are commonly used to treat vertebral fractures. These techniques may be associated with major complications. CASE REPORT: We present here a case of a 64-year-old female patient with T9 and T10 acute osteoporotic fractures, treated previously with vertebroplasty for four levels of osteoporotic vertebral fractures. The patient was treated by T9–T10 vertebroplasty. The post-operative neurological examination was normal. Two hours later, she progressively worsened and developed paraplegia. Magnetic resonance imaging (MRI) revealed a hyper-acute epidural hematoma over the T6 to T10 vertebrae. Evacuation of the epidural hematoma completely resolved her motor weakness. Previous literature reports one case with a thoracolumbar epidural hematoma over T11–L2 and another case with a L1 epidural hematoma after vertebroplasty. CONCLUSIONS: Percutaneous vertebroplasty is generally a safe procedure but can have rare complications. Epidural hematoma after vertebroplasty is one of the uncommon complications. Before percutaneous vertebroplasty, patients should be informed about these rare complications. Prognosis is very good if early intervention is possible.