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Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case
BACKGROUND: Percutaneous vertebroplasty (PVP) is a common procedure, but cement leaks are not uncommon. Leakages do not always have consequences, but rarely complications do occur. Spinal subdural hematomas (sSDHs) are rare and even rarer presented as a complication after PVP. The best management fo...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Association of Neurological Surgeons
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379680/ https://www.ncbi.nlm.nih.gov/pubmed/36273863 http://dx.doi.org/10.3171/CASE21594 |
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author | Yang, Hao-Chien Liu, Heng-Wei Lin, Chien-Min |
author_facet | Yang, Hao-Chien Liu, Heng-Wei Lin, Chien-Min |
author_sort | Yang, Hao-Chien |
collection | PubMed |
description | BACKGROUND: Percutaneous vertebroplasty (PVP) is a common procedure, but cement leaks are not uncommon. Leakages do not always have consequences, but rarely complications do occur. Spinal subdural hematomas (sSDHs) are rare and even rarer presented as a complication after PVP. The best management for sSDH is, therefore, difficult to decide. OBSERVATIONS: The patient first received PVP for acute low back pain after falling. Cement leakages were noted after the procedure, but a sudden new-onset leg weakness only developed later. An emergency lumbar computed tomography scan showed cement leakages anterior to the dural sac; lumbar magnetic resonance imaging revealed a subdural spinal hematoma, and a decompressive laminectomy was performed. During the operation, a small cement mass in the shape of a horn was seen and was believed to have caused the sSDH. Postoperatively, the patient recovered to leg strength 5/5. LESSONS: PVP is considered a low-risk procedure, and cement leaks rarely give rise to complications. However, when leakages present anterior to the dural sac, they may cause dural tear and possible sSDH, regardless of size. This possibility draws attention to keeping awareness of such rare but possible complications after routine PVP procedures. Timely intervention for sSDH is necessary to ensure meaningful recovery. |
format | Online Article Text |
id | pubmed-9379680 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-93796802022-10-04 Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case Yang, Hao-Chien Liu, Heng-Wei Lin, Chien-Min J Neurosurg Case Lessons Case Lesson BACKGROUND: Percutaneous vertebroplasty (PVP) is a common procedure, but cement leaks are not uncommon. Leakages do not always have consequences, but rarely complications do occur. Spinal subdural hematomas (sSDHs) are rare and even rarer presented as a complication after PVP. The best management for sSDH is, therefore, difficult to decide. OBSERVATIONS: The patient first received PVP for acute low back pain after falling. Cement leakages were noted after the procedure, but a sudden new-onset leg weakness only developed later. An emergency lumbar computed tomography scan showed cement leakages anterior to the dural sac; lumbar magnetic resonance imaging revealed a subdural spinal hematoma, and a decompressive laminectomy was performed. During the operation, a small cement mass in the shape of a horn was seen and was believed to have caused the sSDH. Postoperatively, the patient recovered to leg strength 5/5. LESSONS: PVP is considered a low-risk procedure, and cement leaks rarely give rise to complications. However, when leakages present anterior to the dural sac, they may cause dural tear and possible sSDH, regardless of size. This possibility draws attention to keeping awareness of such rare but possible complications after routine PVP procedures. Timely intervention for sSDH is necessary to ensure meaningful recovery. American Association of Neurological Surgeons 2022-03-21 /pmc/articles/PMC9379680/ /pubmed/36273863 http://dx.doi.org/10.3171/CASE21594 Text en © 2022 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Case Lesson Yang, Hao-Chien Liu, Heng-Wei Lin, Chien-Min Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title | Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title_full | Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title_fullStr | Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title_full_unstemmed | Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title_short | Spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
title_sort | spinal subdural hematoma from a ventral dural puncture after percutaneous vertebroplasty: illustrative case |
topic | Case Lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379680/ https://www.ncbi.nlm.nih.gov/pubmed/36273863 http://dx.doi.org/10.3171/CASE21594 |
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