Local Metastases Along the Tract of Needle: A Rare Complication of Vertebroplasty in Treating Spinal Metastases

Study Design. Needle tract seeding after biopsy has been reported by many authors. Since the procedure of needle insertion in vertebroplasty is the same as in biopsy, tumor metastasis along the tract of the needle in vertebroplasty should be possible. Objective. We report local metastases along the needle tract as a rare complication of percutaneous vertebroplasty in treating spinal metastases in a lung cancer patient. Summary of Background Data. The true incidence of tumor implantation along the needle tract may be underestimated as many patients die before the metastases become clinically significant. Methods. A 76-year-old man diagnosed with adenocarcinoma of lung underwent percutaneous vertebroplasty at L1 and L3 vertebral levels due to painful spinal metastases. His condition worsened 3 months later, however, with recurrent back pain and weakness of both legs. Results. MRI of lumbar spine performed post-percutaneous vertebroplasty revealed new contrast-enhanced lesions at the posterior aspect of L1 vertebral body with extension to the adjacent anterior epidural space of L1 and posterior epidural space along T12 to L3 levels with compression of the adjacent dural sac and additional paraspinal involvement. Conclusion. To our knowledge, local metastasis after vertebroplasty in treating spinal metastases has not been reported in the literature. However, this may be a potential complication of vertebroplasty in treating spinal metastases as improvement in cancer treatments occurs with subsequent longer survival times.