Complications of Percutaneous Vertebroplasty

BACKGROUND: Vertebral fractures are common pathologies encountered in neurosurgical practice. It has different origins; osteoporotic, traumatic, or neoplastic. Percutaneous vertebroplasty (PVP) is a procedure used to treat the pain associated with these fractures. This procedure has different complications including cement leakage, which can occur intravenous, into the paravertebral soft tissue, into the intervertebral disc or into the spinal canal affecting foraminal area or epidural space. OBJECTIVE: The aim of this study was to assess the results of vertebroplasty using polymethylmethacrylate cement (PMMA) in 100 patients (120 vertebrae) and its complications. METHODS: A retrospective clinical study of hundred patients with hundred and twenty PVP levels. Sixty patients of the group were osteoporotic. Thirty patients had history of malignancy. Two patients’ imaging showed vertebral haemangiomas and posttraumatic fractures were noticed in eight subjects. Patients were operated between 2010 and 2019 at Suez Canal University Hospitals (Ismailia, Egypt). There were seventy (70%) women and thirty men (30%). The age range of our patients was between 24 to 74 years, their mean age was 58 years. Forty-five patients were operated on at a single level while fifteen subjects had double to triple levels fractures. RESULTS: All our patients had significant back pain with high visual analogue scale (VAS) (70-100), with a mean of ninety-three. Twelve hours postoperatively, 95% of the patients reported pain relief with a VAS mean score of 35. Complications were noticed in 37.5% in all procedures. Leakage occurred in 35% in patients with osteoporosis, 20% in patients with neoplasms and 12.5% in traumatic fractures. Also, three patients had leakage in the spinal canal. CONCLUSION: Vertebroplasty is a minimally invasive surgical technique with a low risk of complications. In more than 95% of patients, vertebroplasty effectively decreases pain. Nearly 40% of patients experience local problems. However, in over 90% of these problems, there was no effect on long term outcomes.