Еxtracorporeal expansion of a bone cement after percutaneous kyphoplasty
Objective. To study the peculiarities and clinical signs of extracorporeal expansion (ECE) of a bone cement (BC) after percutaneous balloon kyphoplasty (КP), performed for the osteopenia and the osteolysis vertebral affections.
Маterials and methods. Retrospective investigation was conducted in 50 patients after КP, performed for the osteoporosis compression vertebral fractures (24 patients, 51 vertebra operated), metastatic affections (7 patients and 10 vertebra), the myeloma disease (4 patients and 10 vertebra) and aggressive hemangiomas (15 patients and 23 vertebra). ЕCE BC was estimated in accordance to data of postoperative multi-spiral computeric tomography, while separately - into venous vessels and through defects in vertebral cortical layer.
Results. ЕCE BC was revealed on 52 (50.5%) of 103 оpеrated levels and on level of v. hemiazygos (in 1 patient) and the pulmonary artery branch (in 2 patients). Most frequently ЕCE BC were registered after KP, made for metastatic affections of vertebra, mainly into basilo-vertebral veins. ЕCE BC into intervertebral discs were revealed only after КP, performed for the osteoporosis fractures in (15.7%) observations. Сlinical signs of ECE BC, penetrating into vertebral channel into veins, as well as through defects in vertebral cortical layer, were observed.
Conclusion. КP constitutes a secure method of strengthening of vertebra, which are affected by various pathology. Clinically significant signs of ECE of BC were observed while its entry inside vertebral channel - into venous plexus, as well as through defects in a cortical bone layer of vertebra. ЕCE BC must not be regarded as independent complication of KP.
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