AN UNUSUAL COMPLICATION OF VERTEBROPLASTY : URINARY INCONTINENCE

We present an unusual complication following a vertebroplasty performed under local anaesthesia and sedation in an osteoporotic patient with a lumbar burst fracture: urinary incontinence. Computed tomography showed retropulsion of the posterior wall of the fracture due to the effect of the cement in a patient who developed postoperative urinary incontinence immediately after a percutaneous vertebroplasty under local anaesthesia. An emergency laminectomy, with reduction of the retropulsed fragment, and instrumentation with a pedicle screw were performed. The urinary incontinence resolved within 24 hours after the second procedure. Surgeons should be aware of the risk of retropulsion in burst fractures, which might result in a neurogenic bladder. In such cases, urgent decompression is a good treatment option.

[1]  Daniel K. Park,et al.  Cement augmentation in vertebral burst fractures. , 2014, Neurosurgical focus.

[2]  P. Boileau,et al.  Vertebral split fractures: technical feasibility of percutaneous vertebroplasty. , 2014, European journal of radiology.

[3]  T. Albert,et al.  Neurological deficit due to cement extravasation following a vertebral augmentation procedure. , 2013, Journal of neurosurgery. Spine.

[4]  C. Bach,et al.  Quantitative Volumetry of Cement Leakage in Viscosity-controlled Vertebroplasty , 2012, Journal of spinal disorders & techniques.

[5]  Hui-lin Yang,et al.  Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures: our experience in preventing cement leakage , 2012, European Spine Journal.

[6]  P. Rommens,et al.  Kyphoplasty as an alternative treatment of traumatic thoracolumbar burst fractures Magerl type A3. , 2012, Injury.

[7]  I. Fineman,et al.  Delayed Neurologic Complications of Vertebral Bone Cement Injections , 2010, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[8]  M. Cosar,et al.  The major complications of transpedicular vertebroplasty. , 2009, Journal of neurosurgery. Spine.

[9]  Shu-Hua Yang,et al.  Surgical removal of extravasated epidural and neuroforaminal polymethylmethacrylate after percutaneous vertebroplasty in the thoracic spine , 2007, European Spine Journal.

[10]  S. Lee,et al.  Percutaneous vertebroplasty for treatment of thoracolumbar spine bursting fracture. , 2004, Surgical neurology.

[11]  K. Harrington,et al.  Major neurological complications following percutaneous vertebroplasty with polymethylmethacrylate : a case report. , 2001, The Journal of bone and joint surgery. American volume.

[12]  R. Assaker,et al.  Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. , 1996, Radiology.